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Baldazzi G, Tessari M, Zamboni M, Pagani A, Zamboni P. The sex prevalence of lower limb varicose vein networks. J Vasc Surg Venous Lymphat Disord 2024:101944. [PMID: 38977197 DOI: 10.1016/j.jvsv.2024.101944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/20/2024] [Accepted: 06/26/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVE To determine the sex prevalence of lower limb varicose networks fed by reflux of the great saphenous vein (GSV), anterior accessory saphenous vein (AASV) and small saphenous vein (SSV) singularly or in combinations. METHODS We scanned by the means of the same Colour Doppler Sonography (CDS) protocol 3000 lower limbs in 1500 consecutive patients, affected by symptomatic chronic venous insufficiency (CVI) during the decade 2013-2023. Limbs with normal venous function, incomplete scans or affected by post thrombotic syndrome, pelvic reflux, venous malformation, phlebolymphedema and CEAP clinical class C5-C6 were excluded from the final analysis. RESULTS Overall, 1072 patients, 252 (23.5%) males and 820 (76.5%) females (p<0.0001), matched for age (p=0.692), were included into the study for a total of 1956 limbs affected by primary CVI, clinical class C2-C4. The main finding was the significant prevalence of varicose networks fed by reflux of the AASV alone (OR 1.96, CI 1.26-3.06, p=0.001) or combined with GSV (OR 1.84, CI 1.34-2.52, p=0.0002) in females. On the other hand, GSV insufficiency alone was significantly prevalent in males (OR 0.54, CI 0.43-0.68, p<0.0001). Moreover, we considered the presence of competent terminal valve (TV+) at the level of the sapheno-femoral junction, which resulted more significantly present in female (OR 1.57, CI 1.12-2.19, p=0.0083); to the contrary incompetent terminal valve (TV-) was more common in males (OR 0.64, CI 0.46-0.89, p=0.0083). Finally, considering reflux in the AASV territory in presence of a TV+, a strong prevalence in females was detected (OR 2.28, CI 1.48-3.52, p=0.0002), while males developed reflux along the GSV when a concomitant TV- was present (OR 0.62, CI 0.41-0.94, p =0.0244). CONCLUSIONS The analysis of the lower limb varicose networks highlights that reflux along the AASV alone, in presence of a competent terminal valve at the junction, or coupled with GSV insufficiency, is more prevalent in females. On the other hand, GSV resulted the main trunk feeding varicose veins in males, in particular when an incompetent terminal valve was detected. Our findings suggest that females could be more prone to develop the varicose vein with an ascending mechanism, whereas in males the descending one seems more common.
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Affiliation(s)
- Giulia Baldazzi
- School of Vascular Surgery, University of Ferrara, Via A. Moro 8, Ferrara, 44124, Italy; Department of Translational Medicine, University of Ferrara, 44121, Ferrara.
| | - Mirko Tessari
- Vascular Diseases Center, University of Ferrara, Via A. Moro 8, Ferrara, 44124 Italy
| | - Matilde Zamboni
- Vascular Surgery Unit, Hospital of Belluno, Viale Europa 22 Belluno, BL 32100, Italy
| | - Anselmo Pagani
- Department of Translational Medicine, University of Ferrara, 44121, Ferrara
| | - Paolo Zamboni
- School of Vascular Surgery, University of Ferrara, Via A. Moro 8, Ferrara, 44124, Italy; Department of Translational Medicine, University of Ferrara, 44121, Ferrara; Vascular Diseases Center, University of Ferrara, Via A. Moro 8, Ferrara, 44124 Italy
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Zhou H, Chen H, Lu H, Wu B, Zhang S, Gu Y, Zhou G, Xiang J, Yang J. Sex differences in mortality and liver-related events in non-alcoholic fatty liver disease: A systematic review and meta-analysis. Liver Int 2024; 44:1600-1609. [PMID: 38506430 DOI: 10.1111/liv.15910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/15/2024] [Accepted: 03/11/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND & AIMS Many systematic reviews explore the association of non-alcoholic fatty liver disease (NAFLD) with mortality, but none of them explores sex-based differences in detail. We aimed to assess whether NAFLD is associated with cause-specific mortality, all-cause mortality, and cancer incidence in both men and women. METHODS The PubMed, Embase, and Medline databases were searched from inception through April 2023 for eligible studies. We separately pooled relative risks (RRs) for men and women using a random effects model. Subsequently, the RRs and 95% CIs (confidence intervals) in each study were used to calculate the women-to-men ratio of RRs (RRR). Furthermore, subgroup analyses were performed to explore the robustness of outcomes. The random-effects model was employed to conduct sensitivity analyses to determine the impact of specific studies on the overall findings. RESULTS The meta-analysis included nine cohort studies comprising 557 614 patients with NAFLD were chosen. Women were 44% more likely than men to get cancer among those with NAFLD (RRR: 1.44; 95% CI: 1.02-2.04; p = .039). However, no sex-related differences were observed between NAFLD and all-cause mortality (RRR: 1.06; 95% CI: 0.56-2.01; p = .861), liver-related mortality (RRR: 1.06; 95% CI: 0.02-69.82; p = .977), cardiovascular mortality (RRR: 1; 95% CI: 0.65-1.53; p = .987) and liver cancer (RRR: 0.76; 95% CI: 0.43-1.36; p = .36). CONCLUSIONS There may be sex variations between NAFLD and the risk of cancer, with the connection being stronger in females than in males.
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Affiliation(s)
- Huimin Zhou
- Department of Medicine, Jiangnan University, Wuxi, Jiangsu, China
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Haiyan Chen
- Department of Medicine, Jiangnan University, Wuxi, Jiangsu, China
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Hanxiao Lu
- Department of Medicine, Jiangnan University, Wuxi, Jiangsu, China
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Bo Wu
- Department of Medicine, Jiangnan University, Wuxi, Jiangsu, China
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Shuo Zhang
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Yuanlong Gu
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Guangwen Zhou
- Department of General Surgery, Shanghai Sixth People's Hospital, Shanghai, China
| | - Jie Xiang
- Wuxi Mingci Cardiovascular Hospital, Wuxi, Jiangsu, China
| | - Jun Yang
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
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Bi J, Wang Y, Wang K, Sun Y, Ye F, Wang X, Pan J. FGF1 attenuates sepsis-induced coagulation dysfunction and hepatic injury via IL6/STAT3 pathway inhibition. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167281. [PMID: 38870868 DOI: 10.1016/j.bbadis.2024.167281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 05/16/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND & AIMS Sepsis, a globally prevalent and highly lethal condition, remains a critical medical challenge. This investigation aims to assess the relevance of FGF1 as a potential therapeutic target for sepsis. METHODS Sepsis was induced in C57BL/6 mice through LPS administration to establish an in vivo animal model. Various in vitro assays were conducted using human umbilical vein endothelial cells to elucidate the role of FGF1 in the disruption of the coagulation system and liver injury associated with sepsis, as well as to explore its underlying molecular mechanisms. RESULTS In in vivo experiments, FGF1 ameliorated coagulation system disruption in septic mice by reducing the levels of pro-inflammatory and coagulation-related factors in the bloodstream. FGF1 also enhanced liver function in septic mice, mitigating liver inflammation and cell apoptosis, fostering liver vascular regeneration, increasing liver blood perfusion, and improving mouse survival. In vitro experiments demonstrated that FGF1 could inhibit LPS-induced inflammatory responses and apoptosis in endothelial cells, fortify endothelial cell barrier function, decrease endothelial cell permeability, promote endothelial cell proliferation, and restore endothelial cell tube-forming ability. Both in vivo and in vitro experiments substantiated that FGF1 improved sepsis by inhibiting the IL-6/STAT3 signaling pathway. CONCLUSION In summary, our study indicates that FGF1 mitigates excessive inflammatory responses in sepsis by suppressing the IL-6/STAT3 signaling pathway, thereby improving systemic blood circulation and ameliorating liver damage in septic organisms. Consequently, this research identifies FGF1 as a potential clinical target for the treatment of human sepsis.
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Affiliation(s)
- Jianing Bi
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China; Zhejiang Key Laboratory of Critical Care Medicine, Wenzhou, China; Wenzhou Key Laboratory of Critical Care and Artificial Intelligence, Wenzhou, China; School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, China.
| | - Yanjing Wang
- School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, China
| | - Kaicheng Wang
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China; Zhejiang Key Laboratory of Critical Care Medicine, Wenzhou, China; Wenzhou Key Laboratory of Critical Care and Artificial Intelligence, Wenzhou, China
| | - Yuanyuan Sun
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China; Zhejiang Key Laboratory of Critical Care Medicine, Wenzhou, China; Wenzhou Key Laboratory of Critical Care and Artificial Intelligence, Wenzhou, China
| | - Fanrong Ye
- Departments of Nuclear Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaojie Wang
- School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, China.
| | - Jingye Pan
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China; Zhejiang Key Laboratory of Critical Care Medicine, Wenzhou, China; Wenzhou Key Laboratory of Critical Care and Artificial Intelligence, Wenzhou, China.
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Severo Sánchez A, González Martín J, de Juan Bagudá J, Morán Fernández L, Muñoz Guijosa C, Arribas Ynsaurriaga F, Delgado JF, García-Cosío Carmena MD. Sex and Gender-related Disparities in Clinical Characteristics and Outcomes in Heart Transplantation. Curr Heart Fail Rep 2024:10.1007/s11897-024-00670-0. [PMID: 38861129 DOI: 10.1007/s11897-024-00670-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE OF REVIEW Limited research has been conducted on sex disparities in heart transplant (HT). The aim of this review is to analyse the available evidence on the influence of sex and gender-related determinants in the entire HT process, as well as to identify areas for further investigation. RECENT FINDINGS Although women make up half of the population affected by heart failure and related mortality, they account for less than a third of HT recipients. Reasons for this inequality include differences in disease course, psychosocial factors, concerns about allosensitisation, and selection or referral bias in female patients. Women are more often listed for HT due to non-ischaemic cardiomyopathy and have a lower burden of cardiovascular risk factors. Although long-term prognosis appears to be similar for both sexes, there are significant disparities in post-HT morbidity and causes of mortality (noting a higher incidence of rejection in women and of malignancy and cardiac allograft vasculopathy in men). Additional research is required to gain a better understanding of the reasons behind gender disparities in eligibility and outcomes following HT. This would enable the fair allocation of resources and enhance patient care.
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Affiliation(s)
- Andrea Severo Sánchez
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Javier González Martín
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), Madrid, Spain
| | - Javier de Juan Bagudá
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Laura Morán Fernández
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), Madrid, Spain
| | - Christian Muñoz Guijosa
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), Madrid, Spain
- Cardiac Surgery Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041, Madrid, Spain
- Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Fernando Arribas Ynsaurriaga
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), Madrid, Spain
- Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan Francisco Delgado
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), Madrid, Spain
- Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - María Dolores García-Cosío Carmena
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), Madrid, Spain.
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Puglisi S, Barač Nekić A, Morelli V, Alessi Y, Fosci M, Pani A, Zibar Tomsic K, Palmieri S, Ferraù F, Pia A, Chiodini I, Kastelan D, Reimondo G, Terzolo M. Are comorbidities of patients with adrenal incidentaloma tied to sex? Front Endocrinol (Lausanne) 2024; 15:1385808. [PMID: 38808113 PMCID: PMC11130385 DOI: 10.3389/fendo.2024.1385808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/18/2024] [Indexed: 05/30/2024] Open
Abstract
Background A recent cross-sectional study showed that both comorbidities and mortality in patients with adrenal incidentaloma (AI) are tied to sex. However, few longitudinal studies evaluated the development of arterial hypertension, hyperglycemia, dyslipidemia and bone impairment in patients with AI. The aim of this study is to analyze the impact of sex in the development of these comorbidities during long-term follow-up. Methods We retrospectively evaluated 189 patients (120 females, 69 males) with AI, from four referral centers in Italy and Croatia. Clinical characteristics, comorbidities and cortisol after 1-mg dexamethasone suppression test (1-mg DST) were assessed at baseline and at last follow-up visit (LFUV). Median follow-up was 52 (Interquartile Range 25-86) months. Results The rates of arterial hypertension and hyperglycemia increased over time both in females (65.8% at baseline versus 77.8% at LFUV, p=0.002; 23.7% at baseline versus 39.6% at LFUV, p<0.001; respectively) and males (58.0% at baseline versus 69.1% at LFUV, p=0.035; 33.8% at baseline versus 54.0% at LFUV, p<0.001; respectively). Patients were stratified in two groups using 1.8 µg/dl as cut-off of cortisol following 1-mg DST: non-functional adrenal tumors (NFAT) and tumors with mild autonomous cortisol secretion (MACS). In the NFAT group (99 patients, females 62.6%), at baseline, we did not observe any difference in clinical characteristics and comorbidities between males and females. At LFUV, males showed a higher frequency of hyperglycemia than females (57.6% versus 33.9%, p=0.03). In the MACS group (89 patients, females 64.0%), at baseline, the prevalence of hypertension, hyperglycemia and dyslipidemia was similar between sexes, despite females were younger (60, IQR 55-69 versus 67.5, IQR 61-73, years; p=0.01). Moreover, females presented higher rates of bone impairment (89.3% versus 54.5%, p=0.02) than males. At LFUV, a similar sex-related pattern was observed. Conclusion Patients with AI frequently develop arterial hypertension and hyperglycemia and should be periodically checked for these comorbidities, regardless of sex. In patients with MACS, the lack of difference between sexes in the frequency of cardiometabolic comorbidities despite that females are younger, and the higher frequency of bone impairment in females, suggest a sex-specific effect of cortisol.
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Affiliation(s)
- Soraya Puglisi
- Department of Clinical and Biological Sciences, Internal Medicine, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Anja Barač Nekić
- Department of Endocrinology, University Hospital Zagreb, Zagreb, Croatia
| | - Valentina Morelli
- Unit for Bone Metabolism Diseases and Diabetes and Lab of Endocrine and Metabolic Research, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - Ylenia Alessi
- Department of Human Pathology G. Barresi, Endocrine Unit, University Hospital G. Martino, University of Messina, Messina, Italy
| | - Michele Fosci
- Department of Medical Sciences and Public Health, Endocrinology and Obesity Unit, University of Cagliari, Cagliari, Italy
| | - Angelo Pani
- Department of Medical Sciences and Public Health, Endocrinology and Obesity Unit, University of Cagliari, Cagliari, Italy
| | - Karin Zibar Tomsic
- Department of Endocrinology, University Hospital Zagreb, Zagreb, Croatia
| | - Serena Palmieri
- Endocrinology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Ferraù
- Department of Human Pathology G. Barresi, Endocrine Unit, University Hospital G. Martino, University of Messina, Messina, Italy
| | - Anna Pia
- Department of Clinical and Biological Sciences, Internal Medicine, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Iacopo Chiodini
- Department of Biotechnology and Translational Medicine, Unit of Endocrinology, Ospedale Niguarda Cà Granda, University of Milan, Milan, Italy
| | - Darko Kastelan
- Department of Endocrinology, University Hospital Zagreb, Zagreb, Croatia
| | - Giuseppe Reimondo
- Department of Clinical and Biological Sciences, Internal Medicine, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Massimo Terzolo
- Department of Clinical and Biological Sciences, Internal Medicine, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
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Rodriguez de Morales YA, Abramson BL. Cardiovascular and physiological risk factors in women at mid-life and beyond. Can J Physiol Pharmacol 2024. [PMID: 38739947 DOI: 10.1139/cjpp-2023-0468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in women. After menopause, sex-specific and gender-specific factors may play an important role in increasing CVD risk, with changes in sex hormones, body fat distribution, lipid and metabolic profile, and structural and functional vascular modifications. Premature and early-onset menopause are detrimental to cardiovascular health due to the early cessation of the protective effect of endogenous estrogen. An independent association of menopause with an increased risk of CVD has been documented in early menopause (<45 years). Sex-related differences are relevant in pharmacokinetics and pharmacodynamics; different enzyme formations, drug compatibility, efficacy, and side effects vary for different sexes. Despite some progress in sex and gender research in CVD, disparities remain. Menopausal hormone therapy (MHT) is available at mid-life for symptoms of menopause and may impact cardiovascular risk. Taken early, MHT may reduce CVD morbimortality. However, this is balanced against the risk of increased thrombosis. This paper reviews physiologic changes that contribute to cardiovascular risk in postmenopausal women and discusses clinical implications. Specifically, it explores the atheroprotective effects of estrogen and MHT and the associations between menopause with lipid levels, hypertension, body composition, and diabetes for women at mid-life and beyond.
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Affiliation(s)
- Yenny A Rodriguez de Morales
- Fellow Cardiac Prevention and Ambulatory Care, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Beth L Abramson
- St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
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Toniutto P, Shalaby S, Mameli L, Morisco F, Gambato M, Cossiga V, Guarino M, Marra F, Brunetto MR, Burra P, Villa E. Role of sex in liver tumor occurrence and clinical outcomes: A comprehensive review. Hepatology 2024; 79:1141-1157. [PMID: 37013373 DOI: 10.1097/hep.0000000000000277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/06/2022] [Indexed: 04/05/2023]
Abstract
Clinical research on sex-based differences in the manifestations, pathophysiology, and prevalence of several diseases, including those affecting the liver, has expanded considerably in recent years. Increasing evidence suggests that liver diseases develop, progress, and respond to treatment differently depending on the sex. These observations support the concept that the liver is a sexually dimorphic organ in which estrogen and androgen receptors are present, which results in disparities between men and women in liver gene expression patterns, immune responses, and the progression of liver damage, including the propensity to develop liver malignancies. Sex hormones play protective or deleterious roles depending on the patient's sex, the severity of the underlying disease, and the nature of precipitating factors. Moreover, obesity, alcohol consumption, and active smoking, as well as social determinants of liver diseases leading to sex-related inequalities, may interact strongly with hormone-related mechanisms of liver damage. Drug-induced liver injury, viral hepatitis, and metabolic liver diseases are influenced by the status of sex hormones. Available data on the roles of sex hormones and gender differences in liver tumor occurrence and clinical outcomes are conflicting. Here, we critically review the main gender-based differences in the molecular mechanisms associated with liver carcinogenesis and the prevalence, prognosis, and treatment of primary and metastatic liver tumors.
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Affiliation(s)
- Pierluigi Toniutto
- Hepatology and Liver Transplantation Unit, Azienda Sanitaria Universitaria Integrata, Department of Medical Area, University of Udine, Udine, Italy
| | - Sarah Shalaby
- Gastroenterology and Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padua University Hospital, Padua, Italy
| | - Laura Mameli
- Liver and Pancreas Transplant Center, Azienda Ospedaliera Brotzu Piazzale Ricchi 1, Cagliari, Italy
| | - Filomena Morisco
- Department of Clinical Medicine and Surgery, Departmental Program "Diseases of the Liver and Biliary System," University of Naples "Federico II," Napoli, Italy
| | - Martina Gambato
- Gastroenterology and Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padua University Hospital, Padua, Italy
| | - Valentina Cossiga
- Department of Clinical Medicine and Surgery, Departmental Program "Diseases of the Liver and Biliary System," University of Naples "Federico II," Napoli, Italy
| | - Maria Guarino
- Department of Clinical Medicine and Surgery, Departmental Program "Diseases of the Liver and Biliary System," University of Naples "Federico II," Napoli, Italy
| | - Fabio Marra
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Patrizia Burra
- Gastroenterology and Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padua University Hospital, Padua, Italy
| | - Erica Villa
- Gastroenterology Department, University of Modena and Reggio Emilia, Modena, Italy
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Ritz SA, Greaves L. We need more-nuanced approaches to exploring sex and gender in research. Nature 2024; 629:34-36. [PMID: 38693410 DOI: 10.1038/d41586-024-01204-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
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Floreani A, Gabbia D, De Martin S. Are Gender Differences Important for Autoimmune Liver Diseases? Life (Basel) 2024; 14:500. [PMID: 38672770 PMCID: PMC11050899 DOI: 10.3390/life14040500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Gender Medicine has had an enormous expansion over the last ten years. Autoimmune liver diseases include several conditions, i.e., autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and conditions involving the liver or biliary tree overlapping with AIH, as well as IgG4-related disease. However, little is known about the impact of sex in the pathogenesis and natural history of these conditions. The purpose of this review is to provide an update of the gender disparities among the autoimmune liver diseases by reviewing the data published from 1999 to 2023. The epidemiology of these diseases has been changing over the last years, due to the amelioration of knowledge in their diagnosis, pathogenesis, and treatment. The clinical data collected so far support the existence of sex differences in the natural history of autoimmune liver diseases. Notably, their history could be longer than that which is now known, with problems being initiated even at a pediatric age. Moreover, gender disparity has been observed during the onset of complications related to end-stage liver disease, including cancer incidence. However, there is still an important debate among researchers about the impact of sex and the pathogenesis of these conditions. With this review, we would like to emphasize the urgency of basic science and clinical research to increase our understanding of the sex differences in autoimmune liver diseases.
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Affiliation(s)
- Annarosa Floreani
- Scientific Consultant IRCCS Negrar, 37024 Verona, Italy
- University of Padova, 35122 Padova, Italy
| | - Daniela Gabbia
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35122 Padova, Italy; (D.G.); (S.D.M.)
| | - Sara De Martin
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35122 Padova, Italy; (D.G.); (S.D.M.)
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Tremblay F, Courtemanche Y, Bélanger RE, Turcotte-Tremblay AM. A systematic review of the association between history of sexually transmitted infections and subsequent condom use in adolescents. BMC Public Health 2024; 24:1000. [PMID: 38600483 PMCID: PMC11007949 DOI: 10.1186/s12889-024-18322-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/10/2024] [Indexed: 04/12/2024] Open
Abstract
Sexually transmitted infections (STIs) are common among adolescents. According to the Health Belief Model, cues to action influence preventive behaviors. Cues to action can include health experiences such as being diagnosed with an STI. The impact of a history of STIs on subsequent condom use among adolescents remains largely unexamined, despite high rates of recurrence and their health impacts. This project aimed to systematically review the literature on the association between curable STIs and subsequent condom use among adolescents. The systematic review, reported following PRISMA guidelines, was conducted using the Joanna Briggs Institute method. Eligible studies, in the form of cohort studies, case-control studies, or cross-sectional studies, targeted adolescents aged 10 to 24, with or without a history of curable STIs; the outcome was subsequent condom use. MEDLINE (Ovid), Embase (Elsevier), and Web of Science were searched from January 2012 to December 2022 with the assistance of an information specialist. Two reviewers independently selected articles and extracted data. Risk of bias analysis was performed using ROBINS-E. The review explores results, with tables, based on population characteristics, exposure, and outcome, and addresses the influence of gender, ethnicity, and age. Of 3088 articles identified, seven studies were retained. Almost all the studies focused on African-American, Nigerian, or Rwandan adolescents, and several included only girls. Among girls, a history of STI increased subsequent condom use in combination with other contraceptive methods (n = 4). Among boys and older adolescents of both genders, a history of STI was associated with a decrease in condom use (n = 3). No study distinguished between different STIs. While all the studies (n = 7) presented a high risk of bias, six did not present a threat to conclusion validity. All the studies indicated that a history of STI could influence subsequent protective behaviors, possibly by acting as a cue to action, as posited by the Health Belief Model. This information enhances our understanding of factors leading to the adoption of preventive health measures among adolescents and could apply to other infectious experiences.Registration The protocol is registered in PROSPERO (CRD42023397443).
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Affiliation(s)
- Frédérique Tremblay
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, 1050, avenue de la Médecine, Room 4633, Québec, (QC), G1V 0A6, Canada.
- Projet COMPASS Québec, VITAM - Centre de recherche en santé durable, CIUSSS-CN and Université Laval, GMF-U Maizerets, 2480, chemin de la Canardière, Québec, (QC), G1J 2G1, Canada.
| | - Yohann Courtemanche
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, 1050, avenue de la Médecine, Room 4633, Québec, (QC), G1V 0A6, Canada
| | - Richard E Bélanger
- Projet COMPASS Québec, VITAM - Centre de recherche en santé durable, CIUSSS-CN and Université Laval, GMF-U Maizerets, 2480, chemin de la Canardière, Québec, (QC), G1J 2G1, Canada
- Department of Pediatrics, Faculty of Medicine, Université Laval, 1050, avenue de la Médecine, Room 4633, Québec, (QC), G1V 0A6, Canada
| | - Anne-Marie Turcotte-Tremblay
- Projet COMPASS Québec, VITAM - Centre de recherche en santé durable, CIUSSS-CN and Université Laval, GMF-U Maizerets, 2480, chemin de la Canardière, Québec, (QC), G1J 2G1, Canada
- Faculy of Nursing, Université Laval, 1050, avenue de la Médecine, Room 3645, Québec, (QC), G1V 0A6, Canada
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11
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Ruggeri RM, Altieri B, Razzore P, Retta F, Sperti E, Scotto G, Brizzi MP, Zumstein L, Pia A, Lania A, Lavezzi E, Nappo G, Laffi A, Albertelli M, Boschetti M, Hasballa I, Veresani A, Prinzi N, Pusceddu S, Oldani S, Nichetti F, Modica R, Minotta R, Liccardi A, Cannavale G, Grossrubatscher EM, Tarsitano MG, Zamponi V, Zatelli MC, Zanata I, Mazzilli R, Appetecchia M, Davì MV, Guarnotta V, Giannetta E, La Salvia A, Fanciulli G, Malandrino P, Isidori AM, Colao A, Faggiano A. Gender-related differences in patients with carcinoid syndrome: new insights from an Italian multicenter cohort study. J Endocrinol Invest 2024; 47:959-971. [PMID: 37837555 DOI: 10.1007/s40618-023-02213-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/25/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND The incidence of neuroendocrine neoplasm (NEN) and related carcinoid syndrome (CaS) has increased markedly in recent decades, and women appear to be more at risk than men. As per other tumors, gender may be relevant in influencing the clinical and prognostic characteristics of NEN-associated CS. However, specific data on carcinoid syndrome (CaS) are still lacking. PURPOSE To evaluate gender differences in clinical presentation and outcome of CaS. METHODS Retrospective analysis of 144 CaS patients from 20 Italian high-volume centers was conducted. Clinical presentation, tumor characteristics, therapies, and outcomes (progression-free survival, PFS, overall survival, OS) were correlated to gender. RESULTS Ninety (62.5%) CaS patients were male. There was no gender difference in the site of primary tumor, tumor grade and clinical stage, as well as in treatments. Men were more frequently smokers (37.2%) and alcohol drinkers (17.8%) than women (9.5%, p = 0.002, and 3.7%, p = 0.004, respectively). Concerning clinical presentation, women showed higher median number of symptoms (p = 0.0007), more frequent abdominal pain, tachycardia, and psychiatric disorders than men (53.3% vs 70.4%, p = 0.044; 6.7% vs 31.5%, p = 0.001; 50.9% vs. 26.7%, p = 0.003, respectively). Lymph node metastases at diagnosis were more frequent in men than in women (80% vs 64.8%; p = 0.04), but no differences in terms of PFS (p = 0.51) and OS (p = 0.64) were found between gender. CONCLUSIONS In this Italian cohort, CaS was slightly more frequent in males than females. Gender-related differences emerged in the clinical presentation of CaS, as well as gender-specific risk factors for CaS development. A gender-driven clinical management of these patients should be advisable.
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Affiliation(s)
- R M Ruggeri
- Endocrinology Unit, Department of Human Pathology of Adulthood and Childhood DETEV, University of Messina, 98125, Messina, Italy
| | - B Altieri
- Division of Endocrinology and Diabetes, Department of Internal Medicine, University of Würzburg, Würzburg, Germany
| | - P Razzore
- SC Endocrinologia, Diabetologia e Malattie del Metabolismo, AO Ordine Mauriziano di Torino, Largo Turati, 62 10128, Turin, Italy
| | - F Retta
- SC Endocrinologia, Diabetologia e Malattie del Metabolismo, AO Ordine Mauriziano di Torino, Largo Turati, 62 10128, Turin, Italy
| | - E Sperti
- SCDU Oncologia, AO Ordine Mauriziano di Torino, Largo Turati, 62 10128, Turin, Italy
| | - G Scotto
- Department of Oncology, University Hospital San Luigi Gonzaga, University of Turin, Orbassano, Turin, Italy
| | - M P Brizzi
- Department of Oncology, University Hospital San Luigi Gonzaga, University of Turin, Orbassano, Turin, Italy
| | - L Zumstein
- Department of Oncology, University Hospital San Luigi Gonzaga, University of Turin, Orbassano, Turin, Italy
| | - A Pia
- Internal Medicine, Department of Clinical and Biological Sciences, S. Luigi Hospital, University of Turin, Turin, Italy
| | - A Lania
- Department of Biomedical Sciences, Humanitas University, 20089, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, Italy
| | - E Lavezzi
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, Italy
| | - G Nappo
- Department of Biomedical Sciences, Humanitas University, 20089, Pieve Emanuele, Italy
- Pancreas Surgery Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, Italy
| | - A Laffi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - M Albertelli
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DIMI), University of Genova, 16132, Genoa, Italy
- Endocrinology Unit, IRCCC Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - M Boschetti
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DIMI), University of Genova, 16132, Genoa, Italy
- Endocrinology Unit, IRCCC Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - I Hasballa
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DIMI), University of Genova, 16132, Genoa, Italy
| | - A Veresani
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DIMI), University of Genova, 16132, Genoa, Italy
| | - N Prinzi
- Medical Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
- First Department of Internal Medicine, San Matteo Hospital Foundation, Padua, Italy
| | - S Pusceddu
- Medical Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
| | - S Oldani
- Medical Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
| | - F Nichetti
- Medical Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
| | - R Modica
- Endocrinology, Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - R Minotta
- Endocrinology, Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - A Liccardi
- Endocrinology, Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - G Cannavale
- Endocrinology, Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | | | - M G Tarsitano
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - V Zamponi
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, ENETS Center of Excellence, Rome, Italy.
| | - M C Zatelli
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - I Zanata
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - R Mazzilli
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, ENETS Center of Excellence, Rome, Italy
| | - M Appetecchia
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M V Davì
- Department of Medicine, Section of Endocrinology, University and Hospital Trust of Verona, Verona, Italy
| | - V Guarnotta
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, 90127, Palermo, Italy
| | - E Giannetta
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A La Salvia
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - G Fanciulli
- Neuroendocrine Tumour Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari-Endocrine Unit, AOU Sassari, Sassari, Italy
| | - P Malandrino
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Catania and Garibaldi, Nesima Medical Center, Catania, Italy
| | - A M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A Colao
- Endocrinology, Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
- UNESCO Chair on Health Education and Sustainable Development, Federico II University, 80138, Naples, Italy
| | - A Faggiano
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, ENETS Center of Excellence, Rome, Italy
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12
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Rio P, Caldarelli M, Chiantore M, Ocarino F, Candelli M, Gasbarrini A, Gambassi G, Cianci R. Immune Cells, Gut Microbiota, and Vaccines: A Gender Perspective. Cells 2024; 13:526. [PMID: 38534370 DOI: 10.3390/cells13060526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/11/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024] Open
Abstract
The development of preventive and therapeutic vaccines has played a crucial role in preventing infections and treating chronic and non-communicable diseases, respectively. For a long time, the influence of sex differences on modifying health and disease has not been addressed in clinical and preclinical studies. The interaction of genetic, epigenetic, and hormonal factors plays a role in the sex-related differences in the epidemiology of diseases, clinical manifestations, and the response to treatment. Moreover, sex is one of the leading factors influencing the gut microbiota composition, which could further explain the different predisposition to diseases in men and women. In the same way, differences between sexes occur also in the immune response to vaccines. This narrative review aims to highlight these differences, focusing on the immune response to vaccines. Comparative data about immune responses, vaccine effectiveness, and side effects are reviewed. Hence, the intricate interplay between sex, immunity, and the gut microbiota will be discussed for its potential role in the response to vaccination. Embracing a sex-oriented perspective in research may improve the efficacy of the immune response and allow the design of tailored vaccine schedules.
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Affiliation(s)
- Pierluigi Rio
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Mario Caldarelli
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Monica Chiantore
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Francesca Ocarino
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Marcello Candelli
- Department of Emergency, Anesthesiological and Reanimation Sciences, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Giovanni Gambassi
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Rossella Cianci
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
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13
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Gilron S, Gabbay-Benziv R, Khoury R. Same disease - different effect: maternal diabetes impact on birth weight stratified by fetal sex. Arch Gynecol Obstet 2024; 309:1001-1007. [PMID: 36856819 DOI: 10.1007/s00404-023-06973-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/09/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND Male-sex is an independent risk factor for adverse perinatal outcomes. One example is gestational diabetes mellitus (GDM), which is associated with large gestational age neonates. It was previously described that fetal glucose metabolism is affected by fetal sex. PURPOSE To examine whether the birth weight of neonates is affected differently by GDM according to fetal sex. METHODS A retrospective normalized cohort analysis, using the open database of 2017 Natality Data from the National Vital Statistics System in the US. We compared the delta in neonatal birth weight, according to fetal sex, between pregnancies with or without GDM. Linear regression was used to take into consideration the effect of multiple confounders. For evaluation whether fetal sex is an independent risk factor for macrosomia (> 4000 and > 4500 g) following pregnancies complicated by GDM we used multivariate logistic regression. RESULTS A significant relationship was found between the sex of the neonate and the delta in birth weight associated with GDM (P-value < 0.0001). The average weight gain in neonates to GDM pregnancies was 71 g in females, and 56 g in males. The prevalence of macrosomia above 4000 g and 4500 g that was attributed to GDM was higher in female-sex neonates compared to male-sex neonates (P < 0.05). CONCLUSION According to our study results, female sex is associated with higher fetal weight gain in pregnancies complicated by GDM. Moreover, macrosomia's rate (> 4000 g and > 4500 g) attributed to GDM raised in a more significant manner in female-sex neonates.
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Affiliation(s)
- Shani Gilron
- Sheba Tel Hashomer Medical Center, Ramat Gan, Israel
| | - Rinat Gabbay-Benziv
- Maternal Fetal Medicine Department, Hillel Yaffe Medical Center, Hadera, Israel
- Institute of Technology, Haifa, Israel
| | - Rasha Khoury
- Maccabi Healthcare Services, Central District, Jaffa, Israel.
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14
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Pelzner K, Fuchs C, Petersen M, Maus M, Bruns CJ, Leers JM. Sex- and gender-specific differences in symptoms and health-related quality of life among patients with gastroesophageal reflux disease. Dis Esophagus 2024; 37:doad064. [PMID: 37963417 DOI: 10.1093/dote/doad064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/01/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
Gastroesophageal Reflux Disease (GERD) is a common chronic gastrointestinal disorder affecting both men and women. Nonerosive reflux disease generally affects more women, whereas GERD complications such as Barrett's esophagus (BE) or esophageal cancer affect more men. The aim of this study was to evaluate sex- and gender-specific symptoms and health-related quality of life (HRQoL) among men and women with GERD. Patients with clinical signs of reflux and completion of 24-hour pH-Impedance testing at the University Hospital Cologne were included into the study. Evaluation of symptoms and HRQoL included the following validated questionnaires: GERD-Health-Related Quality of Life (GERD HRQL), Gastrointestinal Quality of Life Index (GIQLI), and Hospital Anxiety and Depression Scale (HADS). In all, 509 women and 355 men with GERD were included. Men had a significantly higher DeMeester score (60.2 ± 62.6 vs. 43 ± 49.3, P < 0.001) and a higher incidence of BE (18.6 vs. 11.2%, P = 0.006). Women demonstrated significantly higher levels of anxiety (30.9 vs. 14.5%, P = 0.001), more severely impacting symptoms (45.3 ± 11.3 vs. 49.9 ± 12.3, P < 0.001), as well as physical (14.2 ± 5.7 vs. 16.7 ± 5.6, P < 0.001) and social dysfunction (13.3 ± 4.8 vs. 14.8 ± 4.3, P = 0.002). Women further reported a lower HRQoL (85.3 ± 22.7 vs. 92.9 ± 20.8, P < 0.001). Men and women differ on biological, psychological, and sociocultural levels.
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Affiliation(s)
- Kim Pelzner
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
| | - Claudia Fuchs
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
| | - Matti Petersen
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
| | - Martin Maus
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
| | - Christiane J Bruns
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
| | - Jessica M Leers
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
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15
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Kusters CDJ, Paul KC, Lu AT, Ferruci L, Ritz BR, Binder AM, Horvath S. Higher testosterone and testosterone/estradiol ratio in men are associated with decreased Pheno-/GrimAge and DNA-methylation based PAI1. GeroScience 2024; 46:1053-1069. [PMID: 37369886 PMCID: PMC10828310 DOI: 10.1007/s11357-023-00832-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/18/2023] [Indexed: 06/29/2023] Open
Abstract
Sex hormones are hypothesized to drive sex-specific health disparities. Here, we study the association between sex steroid hormones and DNA methylation-based (DNAm) biomarkers of age and mortality risk including Pheno Age Acceleration (AA), Grim AA, and DNAm-based estimators of Plasminogen Activator Inhibitor 1 (PAI1), and leptin concentrations. We pooled data from three population-based cohorts, the Framingham Heart Study Offspring Cohort, the Baltimore Longitudinal Study of Aging, and the InCHIANTI Study, including 1,062 postmenopausal women without hormone therapy and 1,612 men of European descent. Sex-stratified analyses using a linear mixed regression were performed, with a Benjamini-Hochberg (BH) adjustment for multiple testing. Sex Hormone Binding Globulin (SHBG) was associated with a decrease in DNAm PAI1 among men (per 1 standard deviation (SD): -478 pg/mL; 95%CI: -614 to -343; P:1e-11; BH-P: 1e-10), and women (-434 pg/mL; 95%CI: -589 to -279; P:1e-7; BH-P:2e-6). The testosterone/estradiol (TE) ratio was associated with a decrease in Pheno AA (-0.41 years; 95%CI: -0.70 to -0.12; P:0.01; BH-P: 0.04), and DNAm PAI1 (-351 pg/mL; 95%CI: -486 to -217; P:4e-7; BH-P:3e-6) among men. In men, testosterone was associated with a decrease in DNAm PAI1 (-481 pg/mL; 95%CI: -613 to -349; P:2e-12; BH-P:6e-11). SHBG was associated with lower DNAm PAI1 among men and women. Higher testosterone and testosterone/estradiol ratio were associated with lower DNAm PAI and a younger epigenetic age in men. A decrease in DNAm PAI1 is associated with lower mortality and morbidity risk indicating a potential protective effect of testosterone on lifespan and conceivably cardiovascular health via DNAm PAI1.
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Affiliation(s)
- Cynthia D J Kusters
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA.
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
- Department of Epidemiology, Fielding School of Public Health at UCLA, Box 708822, 650 Charles E. Young Drive South, CA, 90095-7088, Los Angeles, USA.
| | - Kimberly C Paul
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Ake T Lu
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA
- Altos Labs, San Diego, USA
| | - Luigi Ferruci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute On Aging, National Institutes of Health, Baltimore, USA
| | - Beate R Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
- Department of Environmental Health, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Alexandra M Binder
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Steve Horvath
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA
- Altos Labs, San Diego, USA
- Department of Biostatistics, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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16
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Graf J, Simoes E, Kranz A, Weinert K, Abele H. The Importance of Gender-Sensitive Health Care in the Context of Pain, Emergency and Vaccination: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:13. [PMID: 38276801 PMCID: PMC10815689 DOI: 10.3390/ijerph21010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024]
Abstract
So far, health care has been insufficiently organized in a gender-sensitive way, which makes the promotion of care that meets the needs of women and men equally emerge as a relevant public health problem. The aim of this narrative review was to outline the need for more gender-sensitive medical care in the context of pain, emergency care and vaccinations. In this narrative review, a selective search was performed in Pubmed, and the databases of the World Health Organization (WHO), the European Institute for Gender Equality and the German Federal Ministry of Health were searched. Study data indicate that there are differences between men and women with regard to the ability to bear pain. On the other hand, socially constructed role expectations in pain and the communication of these are also relevant. Studies indicate that women receive adequate pain medication less often than men with a comparable pain score. Furthermore, study results indicate that the female gender is associated with an increased risk of inadequate emergency care. In terms of vaccine provision, women are less likely than men to utilize or gain access to vaccination services, and there are gender-sensitive differences in vaccine efficacy and safety. Sensitization in teaching, research and care is needed to mitigate gender-specific health inequalities.
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Affiliation(s)
- Joachim Graf
- Institute for Health Sciences, University Hospital Tuebingen, Midwifery Science, Hoppe-Seyler-Str. 9, 72076 Tuebingen, Germany; (A.K.); (K.W.); (H.A.)
| | - Elisabeth Simoes
- Department for Women’s Health, University Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Angela Kranz
- Institute for Health Sciences, University Hospital Tuebingen, Midwifery Science, Hoppe-Seyler-Str. 9, 72076 Tuebingen, Germany; (A.K.); (K.W.); (H.A.)
| | - Konstanze Weinert
- Institute for Health Sciences, University Hospital Tuebingen, Midwifery Science, Hoppe-Seyler-Str. 9, 72076 Tuebingen, Germany; (A.K.); (K.W.); (H.A.)
| | - Harald Abele
- Institute for Health Sciences, University Hospital Tuebingen, Midwifery Science, Hoppe-Seyler-Str. 9, 72076 Tuebingen, Germany; (A.K.); (K.W.); (H.A.)
- Department for Women’s Health, University Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
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17
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Vahl JM, Nagel G, Abou Kors T, Brand M, von Witzleben A, Sonntag M, Grages A, Theodoraki MN, Greve J, Denkinger M, Dallmeier D, Idel C, Stilgenbauer S, Hoffmann TK, Laban S. Regional outcome disparities in German head and neck cancer patients: Shorter survival in Eastern Germany. Cancer Med 2023; 12:21426-21435. [PMID: 38037808 PMCID: PMC10726835 DOI: 10.1002/cam4.6690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION Demographics are important prognostic factors in malignant diseases. A nationwide analysis concerning the prognostic impact of demographics in head and neck cancer (HNC) patients (HNCP) has not been performed previously. METHODS A retrospective analysis of data from the Center for Cancer Registry Data (ZfKD) and the Federal Statistical Office (Destatis) between 2002 and 2017 was performed. A total of 212'920 HNCP were included. Incidence, tumor stage, age development, sex distribution, age-, residence-, and diagnosis-time-specific survival were examined. RESULTS Mean age of HNCP increased more rapidly than in the general population (slope coefficient: 0.29 vs. 0.20; p < 0.0001). Higher age and male sex were associated with a worse prognosis. Whereas overall survival (OS) increased from the early to the later observation period for HNCP <70 years, no OS improvement for HNCP >70 years was found. Furthermore, an OS disadvantage was observed for East Germany compared to West Germany (median 47 vs. 60 months; p < 0.0001). This disparity was associated with a disproportionately high ratio of men in East Germany (men/women: 4.4 vs. 3.1; p < 0.0001) and a lower mean age (61 vs. 63 years; p < 0.0001). In addition to stage, age and sex, residence in East Germany were confirmed as an independent factor for OS in a multivariate analysis. CONCLUSION Finally, three decades after the German reunion, a survival disadvantage for patients in East Germany still exists. This discrepancy may be a result of socioeconomic disparities.
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Affiliation(s)
- Julius M. Vahl
- Department of Otorhinolaryngology and Head & Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center UlmUniversity Medical Center UlmUlmGermany
| | - Gabriele Nagel
- Department of Epidemiology and Medical BiometryUniversity Medical Center UlmUlmGermany
| | - Tsima Abou Kors
- Department of Otorhinolaryngology and Head & Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center UlmUniversity Medical Center UlmUlmGermany
| | - Matthias Brand
- Department of Otorhinolaryngology and Head & Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center UlmUniversity Medical Center UlmUlmGermany
| | - Adrian von Witzleben
- Department of Otorhinolaryngology and Head & Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center UlmUniversity Medical Center UlmUlmGermany
| | - Michael Sonntag
- Department of Otorhinolaryngology and Head & Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center UlmUniversity Medical Center UlmUlmGermany
| | - Ayla Grages
- Department of Otorhinolaryngology and Head & Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center UlmUniversity Medical Center UlmUlmGermany
| | - Marie N. Theodoraki
- Department of Otorhinolaryngology and Head & Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center UlmUniversity Medical Center UlmUlmGermany
| | - Jens Greve
- Department of Otorhinolaryngology and Head & Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center UlmUniversity Medical Center UlmUlmGermany
| | - Michael Denkinger
- Agaplesion Bethesda UlmInstitute of Geriatric Research at Ulm University Medical Center and Geriatric CenterUlmGermany
| | - Dhayana Dallmeier
- Agaplesion Bethesda UlmInstitute of Geriatric Research at Ulm University Medical Center and Geriatric CenterUlmGermany
| | - Christian Idel
- Department of OtorhinolaryngologyUniversity Hospital Schleswig‐HolsteinLübeckGermany
| | | | - Thomas K. Hoffmann
- Department of Otorhinolaryngology and Head & Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center UlmUniversity Medical Center UlmUlmGermany
| | - Simon Laban
- Department of Otorhinolaryngology and Head & Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center UlmUniversity Medical Center UlmUlmGermany
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18
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Klein S, Quartucio E, Miskin B. Hypokinetic Biliary Dyskinesia in a Pediatric Patient: A Case Report. Cureus 2023; 15:e47254. [PMID: 38021582 PMCID: PMC10654687 DOI: 10.7759/cureus.47254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
The diagnosis of biliary dyskinesia (BD) in pediatric patients lacks uniformity across the literature. BD is among the most common reasons for cholecystectomy in pediatric patients. Even still, diagnostic criteria for this disorder, including symptomatology and gallbladder ejection fraction, as well as the symptomatic relief after cholecystectomy, are inconsistent across the literature for the pediatric population. We share the case of an 18-year-old female patient who presented to our clinic for cholecystectomy for a diagnosis of BD. After 10 months of seeking a diagnosis, an eventual nuclear medicine HIDA scan revealed a biliary ejection fraction of 18%, leading her to our care. The patient underwent robotic-assisted laparoscopic cholecystectomy and tolerated the procedure well, reporting a resolution of symptoms on follow-up. The diagnosis and management of BD are complicated by the combination of vague and varied symptomatology and a lack of definitive, uniform diagnostic criteria in the pediatric population. Variability in diagnostic requirements varies between sources. While some look to the interpretation of gallbladder emptying studies, others rely on surgical outcomes. To further complicate diagnosis, some patients experience symptoms that do not correlate with their gallbladder emptying studies. The controversy extends beyond diagnosis as some studies argue against cholecystectomy as a treatment for BD, as it has been shown to not always resolve symptoms. More research should be conducted to identify and establish more consistent diagnostic criteria for BD in the pediatric population, as well as to study symptomatic improvement following cholecystectomy to establish optimal treatment for these patients. Biliary dyskinesia is a relatively common but rather inconsistent diagnosis in the pediatric population, and attention should be turned toward developing uniform and consistent diagnostic criteria in order to optimally recognize, diagnose, and treat these patients, ensuring a shorter time-to-diagnosis and improved quality of life.
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Affiliation(s)
- Sarah Klein
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Elise Quartucio
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Barry Miskin
- General Surgery, Jupiter Medical Center, Jupiter, USA
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19
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Machetanz K, Wang SS, Oberle L, Tatagiba M, Naros G. Sex Differences in Vestibular Schwannoma. Cancers (Basel) 2023; 15:4365. [PMID: 37686642 PMCID: PMC10486905 DOI: 10.3390/cancers15174365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Vestibular schwannoma (VS) are equally common in men and woman. A number of epidemiological studies have reported on sex-specific aspects of incidence, tumor size, tinnitus and hearing loss. However, data on sex-specific, pre- and post-surgically quality of life (QoL) are rare. The objective of the present study was to determine sex-specific aspects on QoL in VS. Health-related QoL was analyzed in 260 patients (112 male/148 female) with unilateral sporadic VS using general (SF-36: general Short-Form Health Survey), disease-specific (PANQOL: Penn Acoustic Neuroma Quality-of-Life Scale, PANQOL) and symptom-specific (DHI: Dizziness Handicap Inventory; HHI: Hearing Handicap Inventory; THI: Tinnitus Handicap Inventory; FDI: Facial Disability Index) QoL questionnaires. Sex differences were evaluated pre- and postoperative by multi- and univariate analyses based on 200 preoperative and 88 postoperative questionnaires. Female patients were significantly more affected by dizziness, headaches, reduced energy and anxiety. Energy and balance changed similarly in both sexes after surgery. However, postoperative women tended to be more affected by facial palsy and headaches than men. Despite the greater physical impairment, general health improved equivalently or even more in female patients than in males. In conclusion, self-rated QoL in VS is significantly affected by sex and surgery. This should be taken into account when counseling VS patients regarding observation, radiotherapy, and surgery.
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Affiliation(s)
- Kathrin Machetanz
- Department of Neurosurgery and Neurotechnology, Eberhard Karls University, 72074 Tuebingen, Germany
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20
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Lego VD. Uncovering the gender health data gap. CAD SAUDE PUBLICA 2023; 39:e00065423. [PMID: 37585901 PMCID: PMC10494683 DOI: 10.1590/0102-311xen065423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 08/18/2023] Open
Affiliation(s)
- Vanessa di Lego
- Vienna Institute of Demography, Austrian Academy of Sciences, Vienna, Austria
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21
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Cecchin E, Posocco B, Mezzalira S, Appetecchia M, Toffoli G. The Role of Gender Pharmacogenetics in the Personalization of Drug Treatment. J Pharmacol Exp Ther 2023; 386:190-197. [PMID: 37001987 DOI: 10.1124/jpet.122.001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 03/21/2023] [Indexed: 07/20/2023] Open
Abstract
The use of pharmacogenetic guidelines in personalizing treatments has shown the potential to reduce interindividual variability in drug response by enabling genotype-matched dosing and drug selection. However, other important factors, such as patient gender, may interact strongly with pharmacogenetics in determining the individual profile of toxicity and efficacy but are still rarely considered when planning pharmacological treatment. The literature indicates that males and females respond differently to drugs, with women being at higher risk for toxicity and having different plasma exposure to drugs at standard doses. Recent studies have shown that pharmacogenetic variants may have different predictive value in different sexes, as in the case of treatment with opioids, angiotensin-converting enzyme inhibitors, or proton pump inhibitors. Of particular interest is the case of treatment with fluoropyrimidines for cancer. A significant increase in toxicity has been described in female patients, with a more pronounced effect of specific DPYD and TYMS polymorphisms also noted. This manuscript reviews the major findings in the field of sex-specific pharmacogenomics. SIGNIFICANCE STATEMENT: Interindividual variability in drug response is an emerging issue in pharmacology. The genetic profile of patients, as well as their gender, may play a role in the identification of patients more exposed to the risk of adverse drug reactions or poor efficacy. This article reviews the current state of research on the interaction between gender and pharmacogenetics in addressing interindividual variability.
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Affiliation(s)
- Erika Cecchin
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
| | - Bianca Posocco
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
| | - Silvia Mezzalira
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
| | - Marialuisa Appetecchia
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
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22
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Kusters CDJ, Paul KC, Lu AT, Ferrucci L, Ritz BR, Binder AM, Horvath S. Higher testosterone and testosterone/estradiol ratio in men are associated with better epigenetic estimators of mortality risk. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.16.23285997. [PMID: 36865294 PMCID: PMC9980235 DOI: 10.1101/2023.02.16.23285997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Introduction Sex hormones are hypothesized to drive sex-specific health disparities. Here, we study the association between sex steroid hormones and DNA methylation-based (DNAm) biomarkers of age and mortality risk including Pheno Age Acceleration (AA), Grim AA, and DNAm-based estimators of Plasminogen Activator Inhibitor 1 (PAI1), and leptin concentrations. Methods We pooled data from three population-based cohorts, the Framingham Heart Study Offspring Cohort (FHS), the Baltimore Longitudinal Study of Aging (BLSA), and the InCHIANTI Study, including 1,062 postmenopausal women without hormone therapy and 1,612 men of European descent. Sex hormone concentrations were standardized with mean 0 and standard deviation of 1, for each study and sex separately. Sex-stratified analyses using a linear mixed regression were performed, with a Benjamini-Hochberg (BH) adjustment for multiple testing. Sensitivity analysis was performed excluding the previously used training-set for the development of Pheno and Grim age. Results Sex Hormone Binding Globulin (SHBG) is associated with a decrease in DNAm PAI1 among men (per 1 standard deviation (SD): -478 pg/mL; 95%CI: -614 to -343; P:1e-11; BH-P: 1e-10), and women (-434 pg/mL; 95%CI: -589 to -279; P:1e-7; BH-P:2e-6). The testosterone/estradiol (TE) ratio was associated with a decrease in Pheno AA (-0.41 years; 95%CI: -0.70 to -0.12; P:0.01; BH-P: 0.04), and DNAm PAI1 (-351 pg/mL; 95%CI: -486 to -217; P:4e-7; BH-P:3e-6) among men. In men, 1 SD increase in total testosterone was associated with a decrease in DNAm PAI1 (-481 pg/mL; 95%CI: -613 to -349; P:2e-12; BH-P:6e-11). Conclusion SHBG was associated with lower DNAm PAI1 among men and women. Higher testosterone and testosterone/estradiol ratio were associated with lower DNAm PAI and a younger epigenetic age in men. A decrease in DNAm PAI1 is associated with lower mortality and morbidity risk indicating a potential protective effect of testosterone on lifespan and conceivably cardiovascular health via DNAm PAI1.
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Affiliation(s)
- Cynthia DJ Kusters
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Kimberly C Paul
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Ake T Lu
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA
- Altos Labs, San Diego, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, USA
| | - Beate R Ritz
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Environmental Health, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Alexandra M Binder
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Steve Horvath
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA
- Altos Labs, San Diego, USA
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
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23
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Lindsay S, Kolne K. A scoping review of the role of gender within speech-language pathology practice. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:231-244. [PMID: 35193452 DOI: 10.1080/17549507.2022.2037707] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
PURPOSE The purpose of this scoping review was to explore the role of gender within speech-language pathology practice. METHOD A scoping review was conducted using the Arksey and O'Malley's framework. Comprehensive and systematic searches of four international databases were conducted. Eligible studies included empirical findings that focussed on gender related to the practice of speech-language pathology, or gender issues amongst clinicians, published in a peer-reviewed journal, in English or French between 1994 and 2020. RESULT Twenty articles met our inclusion criteria, involving 4035 participants across seven countries over a 25-year period. Our conceptual mapping highlighted the following key trends: (1) speech-language pathology is a gendered profession; (2) gender-related factors affecting career choice and job satisfaction; and (3) gender differences among speech-language pathologist practice. CONCLUSION This review highlights the need for further research to understand the role of gender within speech-language pathology practice.
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Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada, and
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Kendall Kolne
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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24
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Regitz-Zagrosek V, Gebhard C. Gender medicine: effects of sex and gender on cardiovascular disease manifestation and outcomes. Nat Rev Cardiol 2023; 20:236-247. [PMID: 36316574 PMCID: PMC9628527 DOI: 10.1038/s41569-022-00797-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 11/06/2022]
Abstract
Despite a growing body of evidence, the distinct contributions of biological sex and the sociocultural dimension of gender to the manifestations and outcomes of ischaemic heart disease and heart failure remain unknown. The intertwining of sex-based differences in genetic and hormonal mechanisms with the complex dimension of gender and its different components and determinants that result in different disease phenotypes in women and men needs to be elucidated. The relative contribution of purely biological factors, such as genes and hormones, to cardiovascular phenotypes and outcomes is not yet fully understood. Increasing awareness of the effects of gender has led to efforts to measure gender in retrospective and prospective clinical studies and the development of gender scores. However, the synergistic or opposing effects of sex and gender on cardiovascular traits and on ischaemic heart disease and heart failure mechanisms have not yet been systematically described. Furthermore, specific considerations of sex-related and gender-related factors in gender dysphoria or in heart-brain interactions and their association with cardiovascular disease are still lacking. In this Review, we summarize contemporary evidence on the distinct effects of sex and gender as well as of their interactions on cardiovascular disease and how they favourably or unfavourably influence the pathogenesis, clinical manifestations and treatment responses in patients with ischaemic heart disease or heart failure.
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Affiliation(s)
- Vera Regitz-Zagrosek
- Institute for Gender in Medicine, Charité University Medicine Berlin, Berlin, Germany.
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
| | - Catherine Gebhard
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- Department of Cardiology, Inselspital Bern University Hospital, Bern, Switzerland
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25
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Shaver N, Bennett A, Beck A, Skidmore B, Traversy G, Brouwers M, Little J, Moher D, Moore A, Persaud N. Health equity considerations in guideline development: a rapid scoping review. CMAJ Open 2023; 11:E357-E371. [PMID: 37171906 PMCID: PMC10139082 DOI: 10.9778/cmajo.20220130] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
BACKGROUND Systematic guidance for considering health equity in guidelines is lacking. This scoping review aims to synthesize current best practices for integrating health equity into guideline development and the benefits or drawbacks of these practices. METHODS We searched Ovid MEDLINE ALL and Embase Classic+Embase on the Ovid platform, CINAHL on EBSCO, and Web of Science (Core Collection) from 2010 to 2022. We searched grey literature from 2015 to 2022, using the Canadian Agency for Drugs and Technologies in Health Grey Matters checklist and searches of potentially relevant websites. Articles were screened independently by 1 reviewer. Proposed best practices, advantages and disadvantages, and tools were extracted independently by 1 reviewer and qualitatively synthesized based on the relevant steps of a comprehensive checklist covering the stages of guideline development. RESULTS We included 26 articles that proposed best practices for incorporating health equity within the guideline development process. These practices were organized under different stages of the development process, including guideline planning, evidence review, guideline development and dissemination. Included studies provided best practices from guideline producers, articles discussing health equity in current guidelines, articles addressing strategies to increase equity in the guideline implementation process, and literature reviews of promising health equity practices. INTERPRETATION Our scoping review identified best practices to incorporate health equity considerations at each phase of guideline development. Identified practices may be used to inform equity-promoting strategies with the guideline development process; however, guideline producers should carefully consider the advantages and disadvantages of best practices when integrating health equity.
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Affiliation(s)
- Nicole Shaver
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Alexandria Bennett
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont.
| | - Andrew Beck
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Becky Skidmore
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Gregory Traversy
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Melissa Brouwers
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - David Moher
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Ainsley Moore
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Navindra Persaud
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
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26
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Spolverato G, Fassan M, Capelli G, Scarpa M, Negro S, Chiminazzo V, Kotsafti A, Angriman I, Campi M, De Simoni O, Ruffolo C, Astghik S, Vignotto C, Scognamiglio F, Becherucci G, Rivella G, Marchegiani F, Facci L, Bergamo F, Brignola S, Businello G, Guzzardo V, Dal Santo L, Salmaso R, Massani M, Pozza A, Cataldo I, Stecca T, Dei Tos AP, Zagonel V, Pilati P, Franzato B, Scapinello A, Pirozzolo G, Recordare A, Merenda R, Bordignon G, Guerriero S, Romiti C, Portale G, Cipollari C, Zizzo M, Porzionato A, Agostini M, Cavallin F, Di Camillo B, Bardini R, Maretto I, Castagliuolo I, Pucciarelli S, Scarpa M. IMMUNOREACT 5: female patients with rectal cancer have better immune editing mechanisms than male patients – a cohort study. Int J Surg 2023; 109:323-332. [PMID: 37093072 PMCID: PMC10389582 DOI: 10.1097/js9.0000000000000214] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/05/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Studies evaluating sex differences in colorectal cancer (CRC) tumor microenvironment are limited, and no previous study has focused on rectal cancer patients' constitutive immune surveillance mechanisms. The authors aimed to assess gender-related differences in the immune microenvironment of rectal cancer patients. METHODS A systematic review and meta-analysis were conducted up to 31 May 2021, including studies focusing on gender-related differences in the CRC tumor microenvironment. Data on the mutational profile of rectal cancer were extracted from the Cancer Genome Atlas (TCGA). A subanalysis of the two IMMUNOREACT trials (NCT04915326 and NCT04917263) was performed, aiming to detect gender-related differences in the immune microenvironment of the healthy mucosa in patients with early (IMMUNOREACT 1 cohort) and locally advanced rectal cancer following neoadjuvant therapy (IMMUNOREACT 2 cohort). In the retrospective IMMUNOREACT 1 cohort (therapy naive), the authors enrolled 442 patients (177 female and 265 male), while in the retrospective IMMUNOREACT 2 cohort (patients who had neoadjuvant therapy), we enrolled 264 patients (80 female and 184 male). In the prospective IMMUNOREACT 1 cohort (therapy naive), the authors enrolled 72 patients (26 female and 46 male), while in the prospective IMMUNOREACT 2 cohort (patients who had neoadjuvant therapy), the authors enrolled 105 patients (42 female and 63 male). RESULTS Seven studies reported PD-L1 expression in the CRC microenvironment, but no significant difference could be identified between the sexes. In the TGCA series, mutations of SYNE1 and RYR2 were significantly more frequent in male patients with rectal cancer. In the IMMUNOREACT 1 cohort, male patients had a higher expression of epithelial cells expressing HLA class I, while female patients had a higher number of activated CD4+Th1 cells. Female patients in the IMMUNOREACT 2 cohort showed a higher infiltration of epithelial cells expressing CD86 and activated cytotoxic T cells (P=0.01). CONCLUSIONS Male patients have more frequent oncogene mutations associated with a lower expression of T-cell activation genes. In the healthy mucosa of female patients, more Th1 cells and cytotoxic T cells suggest a potentially better immune response to the tumor. Sex should be considered when defining the treatment strategy for rectal cancer patients or designing prognostic scores.
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Cotinine as a Sentinel of Canine Exposure to Tobacco Smoke. Animals (Basel) 2023; 13:ani13040693. [PMID: 36830480 PMCID: PMC9952721 DOI: 10.3390/ani13040693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
The adverse health effects of both active and passive tobacco smoke have been well-known in humans for a long time. It is presumable that even pets, which intimately share the owner's lifestyle, may be exposed to the same risks. This study aimed to detect and quantify cotinine (a metabolite of nicotine) in the serum and hair of dogs using a specific commercial ELISA immunoassay kit. A total of 32 dogs, 16 exposed and 16 unexposed to the owner's smoke, were enrolled. The cotinine concentration was higher in the exposed than the unexposed group in both matrices (p < 0.001), with greater values in serum than in hair (p < 0.001). Exposed bitches had higher hair cotinine than male dogs (p < 0.001). Conversely, serum and fur cotinine concentrations were lower in female than male dogs of the unexposed group (p < 0.01). The exposure intensity, age, and weight of the dogs did not affect cotinine concentrations. A cut-off value of 2.78 ng/mL and 1.13 ng/mL cotinine concentration in serum and fur, respectively, was estimated to distinguish between the exposed and unexposed dogs. Cotinine was confirmed as a valuable marker of passive smoking also in dogs. Although owners do not perceive secondhand smoke as a risk for their dogs, greater awareness should be advisable, especially in pregnant animals.
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Ivan S, Daniela O, Jaroslava BD. Sex differences matter: Males and females are equal but not the same. Physiol Behav 2023; 259:114038. [PMID: 36423797 DOI: 10.1016/j.physbeh.2022.114038] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 11/23/2022]
Abstract
Sex differences between males and females can be detected early in life. They are present also later even to a much greater extent affecting our life in adulthood and a wide spectrum of physical, psychological, cognitive, and behavioral characteristics. Moreover, sex differences matter also in individual's health and disease. In this article, we reviewed at first the sex differences in brain organization and function with respect to the underlying biological mechanisms. Since the individual functional differences in the brain, in turn, shape the behavior, sex-specific psychological/behavioral differences that can be observed in infants but also adults are consequently addressed. Finally, we briefly mention sex-dependent variations in susceptibility to selected disorders as well as their pathophysiology, diagnosis, and response to therapy. The understanding of biologically determined variability between males and females can have important implications, especially in gender-specific health care. We have the impression that it is very important to emphasize that sex matters. Males and females are differently programmed by nature, and it must be respected. Even though we as males and females are not the same, we would like to emphasize that we are still equal and together form a worthy colorful continuum.
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Affiliation(s)
- Szadvári Ivan
- Institute of Physiology, Medical School, Comenius University, Bratislava, Slovakia
| | - Ostatníková Daniela
- Institute of Physiology, Medical School, Comenius University, Bratislava, Slovakia
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Poley M, Chen G, Sharf-Pauker N, Avital A, Kaduri M, Sela M, Raimundo PM, Koren L, Arber S, Egorov E, Shainsky J, Shklover J, Schroeder A. Sex‐Based Differences in the Biodistribution of Nanoparticles and Their Effect on Hormonal, Immune, and Metabolic Function. ADVANCED NANOBIOMED RESEARCH 2022. [DOI: 10.1002/anbr.202200089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Maria Poley
- Laboratory for Targeted Drug Delivery and Personalized Medicine Technologies Department of Chemical Engineering Technion – Israel Institute of Technology Haifa 32000 Israel
| | - Gal Chen
- Laboratory for Targeted Drug Delivery and Personalized Medicine Technologies Department of Chemical Engineering Technion – Israel Institute of Technology Haifa 32000 Israel
| | - Noga Sharf-Pauker
- The Norman Seiden Multidisciplinary Program for Nanoscience and Nanotechnology Technion – Israel Institute of Technology Haifa 32000 Israel
| | - Aviram Avital
- The Norman Seiden Multidisciplinary Program for Nanoscience and Nanotechnology Technion – Israel Institute of Technology Haifa 32000 Israel
| | - Maya Kaduri
- Laboratory for Targeted Drug Delivery and Personalized Medicine Technologies Department of Chemical Engineering Technion – Israel Institute of Technology Haifa 32000 Israel
| | - Mor Sela
- Laboratory for Targeted Drug Delivery and Personalized Medicine Technologies Department of Chemical Engineering Technion – Israel Institute of Technology Haifa 32000 Israel
| | - Patricia Mora Raimundo
- Laboratory for Targeted Drug Delivery and Personalized Medicine Technologies Department of Chemical Engineering Technion – Israel Institute of Technology Haifa 32000 Israel
| | - Lilach Koren
- Laboratory for Targeted Drug Delivery and Personalized Medicine Technologies Department of Chemical Engineering Technion – Israel Institute of Technology Haifa 32000 Israel
| | - Sivan Arber
- Laboratory for Targeted Drug Delivery and Personalized Medicine Technologies Department of Chemical Engineering Technion – Israel Institute of Technology Haifa 32000 Israel
| | - Egor Egorov
- Laboratory for Targeted Drug Delivery and Personalized Medicine Technologies Department of Chemical Engineering Technion – Israel Institute of Technology Haifa 32000 Israel
| | - Janna Shainsky
- Laboratory for Targeted Drug Delivery and Personalized Medicine Technologies Department of Chemical Engineering Technion – Israel Institute of Technology Haifa 32000 Israel
| | - Jeny Shklover
- Laboratory for Targeted Drug Delivery and Personalized Medicine Technologies Department of Chemical Engineering Technion – Israel Institute of Technology Haifa 32000 Israel
| | - Avi Schroeder
- Laboratory for Targeted Drug Delivery and Personalized Medicine Technologies Department of Chemical Engineering Technion – Israel Institute of Technology Haifa 32000 Israel
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Niso G, Botvinik-Nezer R, Appelhoff S, De La Vega A, Esteban O, Etzel JA, Finc K, Ganz M, Gau R, Halchenko YO, Herholz P, Karakuzu A, Keator DB, Markiewicz CJ, Maumet C, Pernet CR, Pestilli F, Queder N, Schmitt T, Sójka W, Wagner AS, Whitaker KJ, Rieger JW. Open and reproducible neuroimaging: From study inception to publication. Neuroimage 2022; 263:119623. [PMID: 36100172 PMCID: PMC10008521 DOI: 10.1016/j.neuroimage.2022.119623] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/17/2022] [Accepted: 09/09/2022] [Indexed: 10/31/2022] Open
Abstract
Empirical observations of how labs conduct research indicate that the adoption rate of open practices for transparent, reproducible, and collaborative science remains in its infancy. This is at odds with the overwhelming evidence for the necessity of these practices and their benefits for individual researchers, scientific progress, and society in general. To date, information required for implementing open science practices throughout the different steps of a research project is scattered among many different sources. Even experienced researchers in the topic find it hard to navigate the ecosystem of tools and to make sustainable choices. Here, we provide an integrated overview of community-developed resources that can support collaborative, open, reproducible, replicable, robust and generalizable neuroimaging throughout the entire research cycle from inception to publication and across different neuroimaging modalities. We review tools and practices supporting study inception and planning, data acquisition, research data management, data processing and analysis, and research dissemination. An online version of this resource can be found at https://oreoni.github.io. We believe it will prove helpful for researchers and institutions to make a successful and sustainable move towards open and reproducible science and to eventually take an active role in its future development.
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Affiliation(s)
- Guiomar Niso
- Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA; Universidad Politecnica de Madrid, Madrid and CIBER-BBN, Spain; Instituto Cajal, CSIC, Madrid, Spain.
| | - Rotem Botvinik-Nezer
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA.
| | - Stefan Appelhoff
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
| | | | - Oscar Esteban
- Dept. of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Department of Psychology, Stanford University, Stanford, CA, USA
| | - Joset A Etzel
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Karolina Finc
- Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Toruń, Poland
| | - Melanie Ganz
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark; Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Rémi Gau
- Institute of Psychology, Université catholique de Louvain, Louvain la Neuve, Belgium
| | - Yaroslav O Halchenko
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Peer Herholz
- Montreal Neurological Institute-Hospital, McGill University, Montréal, Quebec, Canada
| | - Agah Karakuzu
- Biomedical Engineering Institute, Polytechnique Montréal, Montréal, Quebec, Canada; Montréal Heart Institute, Montréal, Quebec, Canada
| | - David B Keator
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | | | - Camille Maumet
- Inria, Univ Rennes, CNRS, Inserm - IRISA UMR 6074, Empenn ERL U 1228, Rennes, France
| | - Cyril R Pernet
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - Franco Pestilli
- Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA; Department of Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Nazek Queder
- Montreal Neurological Institute-Hospital, McGill University, Montréal, Quebec, Canada; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Tina Schmitt
- Neuroimaging Unit, Carl-von-Ossietzky Universität, Oldenburg, Germany
| | - Weronika Sójka
- Faculty of Philosophy and Social Sciences, Nicolaus Copernicus University, Toruń, Poland
| | - Adina S Wagner
- Institute for Neuroscience and Medicine, Research Centre Juelich, Germany
| | | | - Jochem W Rieger
- Neuroimaging Unit, Carl-von-Ossietzky Universität, Oldenburg, Germany; Department of Psychology, Carl-von-Ossietzky Universität, Oldenburg, Germany.
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Yoon HY, Lee H, Yee J, Gwak HS. Global Research Trends of Gender-Related Artificial Intelligence in Medicine Between 2001-2020: A Bibliometric Study. Front Med (Lausanne) 2022; 9:868040. [PMID: 35655848 PMCID: PMC9152019 DOI: 10.3389/fmed.2022.868040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/27/2022] [Indexed: 11/15/2022] Open
Abstract
This study aimed to assess the research on medical Artificial intelligence (AI) related to sex/gender and explore global research trends over the past 20 years. We searched the Web of Science (WoS) for gender-related medical AI publications from 2001 to 2020. We extracted the bibliometric data and calculated the annual growth of publications, Specialization Index, and Category Normalized Citation Impact. We also analyzed the publication distributions by institution, author, WoS subject category, and journal. A total of 3,110 papers were included in the bibliometric analysis. The number of publications continuously increased over time, with a steep increase between 2016 and 2020. The United States of America and Harvard University were the country and institution that had the largest number of publications. Surgery and urology nephrology were the most common subject categories of WoS. The most occurred keywords were machine learning, classification, risk, outcomes, diagnosis, and surgery. Despite increased interest, gender-related research is still low in medical AI field and further research is needed.
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Affiliation(s)
- Ha Young Yoon
- College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Heisook Lee
- Korea Center for Gendered Innovations for Science and Technology Research, Seoul, South Korea
| | - Jeong Yee
- College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Hye Sun Gwak
- College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
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Ruggeri RM, Altieri B, Grossrubatcher E, Minotta R, Tarsitano MG, Zamponi V, MIsidori A, Faggiano A, Colao AM. Sex differences in carcinoid syndrome: A gap to be closed. Rev Endocr Metab Disord 2022; 23:659-669. [PMID: 35292889 DOI: 10.1007/s11154-022-09719-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 12/17/2022]
Abstract
The incidence of neuroendocrine neoplasms and related carcinoid syndrome (CS) has markedly increased over the last decades and women seem to be more at risk than men for developing CS. Nevertheless, very few studies have investigated sex differences in clinical presentation and outcomes of CS. However, as per other tumours, sex might be relevant in influencing tumour localization, delay in diagnosis, clinical outcomes, prognosis and overall survival in CS. The present review was aimed at evaluating sex differences in CS, as they emerge from an extensive search of the recent literature. It emerged that CS occurs more frequently in female than in male patients with NENs and women seem to have a better prognosis and a slight advantage in overall survival and response to therapy. Moreover, the disease likely impacts differently the quality of life of men and women, with different psychological and social consequences. Nevertheless, sex differences, even if partially known, are deeply underestimated in clinical practice and data from clinical trials are lacking. There is urgent need to increase our understanding of the sex-related differences of CS, in order to define tailored strategies of management of the disease, improving both the quality of life and the prognosis of affected patients.
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Affiliation(s)
- Rosaria M Ruggeri
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Messina, Italy.
| | - Barbara Altieri
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | | | - Roberto Minotta
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy
| | | | - Virginia Zamponi
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Andrea MIsidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Antongiulio Faggiano
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Anna Maria Colao
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, Naples, Italy
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Funer F. The Deception of Certainty: how Non-Interpretable Machine Learning Outcomes Challenge the Epistemic Authority of Physicians. A deliberative-relational Approach. MEDICINE, HEALTH CARE AND PHILOSOPHY 2022; 25:167-178. [PMID: 35538267 PMCID: PMC9089291 DOI: 10.1007/s11019-022-10076-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/03/2022] [Accepted: 03/03/2022] [Indexed: 02/06/2023]
Abstract
Developments in Machine Learning (ML) have attracted attention in a wide range of healthcare fields to improve medical practice and the benefit of patients. Particularly, this should be achieved by providing more or less automated decision recommendations to the treating physician. However, some hopes placed in ML for healthcare seem to be disappointed, at least in part, by a lack of transparency or traceability. Skepticism exists primarily in the fact that the physician, as the person responsible for diagnosis, therapy, and care, has no or insufficient insight into how such recommendations are reached. The following paper aims to make understandable the specificity of the deliberative model of a physician-patient relationship that has been achieved over decades. By outlining the (social-)epistemic and inherently normative relationship between physicians and patients, I want to show how this relationship might be altered by non-traceable ML recommendations. With respect to some healthcare decisions, such changes in deliberative practice may create normatively far-reaching challenges. Therefore, in the future, a differentiation of decision-making situations in healthcare with respect to the necessary depth of insight into the process of outcome generation seems essential.
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How to Integrate Sex and Gender Medicine into Medical and Allied Health Profession Undergraduate, Graduate, and Post-Graduate Education: Insights from a Rapid Systematic Literature Review and a Thematic Meta-Synthesis. J Pers Med 2022; 12:jpm12040612. [PMID: 35455728 PMCID: PMC9026631 DOI: 10.3390/jpm12040612] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 12/10/2022] Open
Abstract
Sex and gender are concepts that are often misunderstood and misused, being utilized in a biased, preconceived, interchangeable way. Sex and gender medicine is generally overlooked, despite the profound impact of sex and gender on health outcomes. The aims of the present rapid systematic literature review were (i) to assess the extent to which sex- and gender-sensitive topics are covered in medical courses; (ii) to assess the need for and willingness toward integrating/incorporating sex and gender medicine into health-related education; (iii) to identify barriers and facilitators of the process of implementation of sex and gender medicine in medical teaching, mentoring, and training; and (iv) to evaluate the effectiveness of interventional projects targeting curriculum building and improvement for future gender-sensitive physicians. Seven themes were identified by means of a thematic analysis, namely, (i) how much sex- and gender-based medicine is covered by medical courses and integrated into current medical curricula, (ii) the knowledge of sex and gender medicine among medical and allied health profession students, (iii) the need for and willingness toward acquiring sex- and gender-sensitive skills, (iv) how to integrate sex- and gender-based medicine into medical curricula in terms of barriers and facilitators, (v) existing platforms and tools to share knowledge related to sex and gender medicine, (vi) sex- and gender-based medicine aspects in the post-medical education, and (vii) the impact of sex- and gender-sensitive topics integrated into medical curricula. Based on the identified gaps in knowledge, further high-quality, randomized trials with larger samples are urgently warranted to fill these gaps in the field of implementation of gender medicine in educating and training future gender-sensitive physicians.
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Erdmann A, Rehmann-Sutter C, Bozzaro C. Clinicians’ and Researchers’ Views on Precision Medicine in Chronic Inflammation: Practices, Benefits and Challenges. J Pers Med 2022; 12:jpm12040574. [PMID: 35455690 PMCID: PMC9031131 DOI: 10.3390/jpm12040574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Due to the high burden of diseases with chronic inflammation as an underlying condition, great expectations are placed in the development of precision medicine (PM). Our research explores the benefits and possible risks of this development from the perspective of clinicians and researchers in the field. We have asked these professionals about the current state of their research and their expectations, concerns, values and attitudes regarding PM. (2) Methods: Following a grounded theory approach, we conducted qualitative interviews with 17 clinicians and researchers. For respondent validation, we discussed the findings with the participants in a validation workshop. (3) Results: Professionals expect multiple benefits from PM in chronic inflammation. They provided their concepts of professionals’ and patients’ work in the development of PM in chronic inflammatory diseases. Ethical, process-related and economic challenges were raised regarding the lack of integration of data from minority groups, the risk of data misuse and discrimination, the potential risk of no therapy being available for small strata, the lack of professional support and political measures in developing a healthy lifestyle, the problem of difficult access to the inflammation clinic for some populations and the difficulty of financing PM for all. (4) Conclusions: In the further research, development and implementation of PM, these ethical challenges need to be adequately addressed.
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Affiliation(s)
- Anke Erdmann
- Institute for Experimental Medicine, Medical Ethics Working Group, Kiel University, 24105 Kiel, Germany;
- Correspondence: ; Tel.: +49-431-500-30332
| | - Christoph Rehmann-Sutter
- Institute for History of Medicine and Science Studies, University of Lübeck, 23552 Lübeck, Germany;
| | - Claudia Bozzaro
- Institute for Experimental Medicine, Medical Ethics Working Group, Kiel University, 24105 Kiel, Germany;
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Webster-Cordero F, Giménez-Llort L. The Challenge of Subjective Cognitive Complaints and Executive Functions in Middle-Aged Adults as a Preclinical Stage of Dementia: A Systematic Review. Geriatrics (Basel) 2022; 7:geriatrics7020030. [PMID: 35314602 PMCID: PMC8938842 DOI: 10.3390/geriatrics7020030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/04/2022] [Indexed: 02/04/2023] Open
Abstract
Subjective cognitive complaints correspond to a heterogeneous construct that frequently occurs in the early stages of older adult life. Despite being a common source of worry for middle-aged people, it can be underestimated when clinical and neuropsychological assessments discard any underlying pathological processes. Negative age stereotyping but also self-stereotyping can contribute to doing so. Although its diagnosis is a challenge, its implication as a possible predictor of mild cognitive impairment or dementia increases the interest in its early diagnosis and intervention. The present systematic review analyzes the empirical data on the relationship between these complaints and early executive dysfunction with possible predictive value for preclinical stages of dementia. The sixteen papers obtained from the PubMed and Embase databases were exploratory, cross-sectional and prospective in scope. The studies corroborated the relationship between subjective cognitive complaints and some executive processes, which is noteworthy since many people with subjective executive complaints progress to dementia. The relational studies confirmed that impaired executive performance is associated with CSF biomarkers and reduced cortical volume in specific brain regions. However, the heterogeneity of reports in these studies demands stronger efforts in future research with specific tools applied in clinical and neuropsychological assessments and analyzed under a gender perspective.
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Affiliation(s)
- Felipe Webster-Cordero
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, E-08193 Barcelona, Spain
- Hospital Santa Inés, Cuenca 010107, Ecuador
- Correspondence: (F.W.-C.); (L.G.-L.); Tel.: +593-98-488-4724 (F.W.-C.); +34-93-5812378 (L.G.-L.)
| | - Lydia Giménez-Llort
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, E-08193 Barcelona, Spain
- Institut de Neurociències, Universitat Autònoma de Barcelona, E-08193 Barcelona, Spain
- Correspondence: (F.W.-C.); (L.G.-L.); Tel.: +593-98-488-4724 (F.W.-C.); +34-93-5812378 (L.G.-L.)
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Bert F, Boietti E, Rousset S, Pompili E, Franzini Tibaldeo E, Gea M, Scaioli G, Siliquini R. Gender sensitivity and stereotypes in medical university students: An Italian cross-sectional study. PLoS One 2022; 17:e0262324. [PMID: 34990471 PMCID: PMC8735594 DOI: 10.1371/journal.pone.0262324] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/22/2021] [Indexed: 11/19/2022] Open
Abstract
Gender medicine is crucial to reduce health inequalities. Knowledge about students’ attitudes and beliefs regarding men, women and gender is important to improve gender medicine courses. The aim of this study is to evaluate gender stereotypes and its predictors in Italian medical students. We performed an online cross-sectional study among students from the University of Turin. We used the validated Nijmegen Gender Awareness Scale in Medicine scale to explore gender sensitivity and stereotypes. Multivariable logistic regression model was performed to explore potential predictors of gender awareness. We enrolled 430 students. Female sex, a better knowledge on gender medicine and having had a tutor aware of gender issues are associated with higher gender sensitivity. Older age, a better knowledge on gender medicine and having had a tutor sensitive to gender issues were predictors of more stereotyped opinions towards patients. Having had a tutor aware of gender medicine, male sex and older age were associated with more stereotypes towards doctors. Italian students have high gender sensitivity and low gender stereotypes. Age, higher knowledge of gender medicine and having had a tutor that considered gender were associated with higher gender stereotypes. Focusing on gender awareness in medical schools can contribute to a better care.
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Affiliation(s)
- Fabrizio Bert
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - Edoardo Boietti
- Department of Public Health Sciences, University of Turin, Turin, Italy
- * E-mail:
| | - Stefano Rousset
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - Erika Pompili
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | | | - Marta Gea
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - Giacomo Scaioli
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - Roberta Siliquini
- Department of Public Health Sciences, University of Turin, Turin, Italy
- AOU City of Health and Science, University of Turin, Turin, Italy
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Wu J, Zhang L, Wang X. Host Sex Steroids Interact With Virus Infection: New Insights Into Sex Disparity in Infectious Diseases. Front Microbiol 2021; 12:747347. [PMID: 34803967 PMCID: PMC8600311 DOI: 10.3389/fmicb.2021.747347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/27/2021] [Indexed: 01/08/2023] Open
Abstract
Sex hormones are steroid hormones synthesized from the gonads of animals and tissues such as the placenta and adrenocortical reticular zone. The physiological functions of sex hormones are complex. Sex hormones are not only pathologically correlated with many diseases of the reproductive system, but are etiological factors in some viral infectious diseases, including disease caused by infections of coronaviruses, herpesviruses, hepatitis viruses, and other kinds of human viruses, which either exhibit a male propensity in clinical practice, or crosstalk with androgen receptor (AR)-related pathways in viral pathogenesis. Due to the global pandemic of coronavirus disease 2019 (COVID-19), the role of androgen/AR in viral infectious disease is highlighted again, majorly representing by the recent advances of AR-responsive gene of transmembrane protease/serine subfamily member 2 (TMPRSS2), which proteolytically activates the receptor-mediated virus entry by many coronaviruses and influenza virus, along with the role of androgen-mediated signaling for the transcription of hepatitis B virus (HBV), and the role of sex hormone responsive genes during Zika virus (ZIKV) pathogenesis, et al. Collectively, we propose to provide a comprehensive overview of the role of male sex hormones during multiple phases in the life cycle of different human viruses, which may be partly responsible for the sex-specific prevalence, severity and mortality of some diseases, therefore, may provide clues to develop more efficient prevention and treatment strategies for high-risk populations.
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Affiliation(s)
- Jinfeng Wu
- Key Laboratory of Gastrointestinal Cancer (Ministry of Education), School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Lei Zhang
- Key Laboratory of Gastrointestinal Cancer (Ministry of Education), School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Xing Wang
- Key Laboratory of Gastrointestinal Cancer (Ministry of Education), School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
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Shashar R, Amiel GE. Is It Time for a "Me-Too" Movement Against Attitudes Towards Women Suffering from Nongynecological Malignancies? JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:897-898. [PMID: 34550558 DOI: 10.1007/s13187-021-02092-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Reut Shashar
- Department of Urology, RAMBAM Healthcare Campus, Haifa, Israel
| | - Gilad E Amiel
- Department of Urology, RAMBAM Healthcare Campus, Haifa, Israel.
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Shai A, Koffler S, Hashiloni-Dolev Y. Feminism, gender medicine and beyond: a feminist analysis of "gender medicine". Int J Equity Health 2021; 20:177. [PMID: 34344374 PMCID: PMC8330093 DOI: 10.1186/s12939-021-01511-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 07/12/2021] [Indexed: 11/29/2022] Open
Abstract
The feminist women's health movement empowered women's knowledge regarding their health and battled against paternalistic and oppressive practices within healthcare systems. Gender Medicine (GM) is a new discipline that studies the effect of sex/gender on general health. The international society for gender medicine (IGM) was embraced by the FDA and granted funds by the European Union to formulate policies for medical practice and research.We conducted a review of IGM publications and policy statements in scientific journals and popular media. We found that while biological differences between men and women are emphasized, the impact of society on women is under- represented. The effect of gender-related violence, race, ethnic conflicts, poverty, immigration and discrimination on women's health is seldom recognized. Contrary to feminist practice, GM is practiced by physicians and scientists, neglecting voices of other disciplines and of women themselves.In this article we show that while GM may promote some aspects of women's health, at the same time it reaffirms conservative positions on sex and gender that can serve to justify discrimination and disregard the impact of society on women's lives and health. An alternative approach, that integrates feminist thinking and practices into medical science, practice and policies is likely to result in a deep and beneficiary change in women's health worldwide.
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Affiliation(s)
- Ayelet Shai
- Oncology Department, Gailee Medical Center, 89 Meona rd, Nahariya, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Shahar Koffler
- Pediatrics Department, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Yael Hashiloni-Dolev
- Sociology and Anthropology Department, Ben-Gurion University of the Negev, Ben- Gurion Blvd 1, Be’er-Sheva, Israel
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Belimezi M, Kalliaropoulos A, Jiménez J, Garcia I, Mentis AFA, Chrousos GP. Age at sampling and sex distribution of AChRAb vs. MuSKAb myasthenia gravis in a large Greek population. Clin Neurol Neurosurg 2021; 208:106847. [PMID: 34343914 DOI: 10.1016/j.clineuro.2021.106847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Myasthenia gravis (MG) is a typical B-cell-mediated neuromuscular junction disease that can be classified into seropositive and seronegative subtypes. Association of patients' age at sampling and sex with the two major seropositive MG subcategories, i.e., MGs linked to antibodies directed against the acetylcholine receptor (AChRAb) and against the muscle-specific kinase (MuSKAb), has not been compared in a large population. METHODS We performed a retrospective analysis of samples from patients with MG in Greece who underwent neurochemical diagnostic evaluation between January 2, 2013, and August 31, 2016. RESULTS Overall, 1620 adult (623 male and 997 female patients; male-to-female ratio = 0.62) and 51 pediatric patients were found to be seropositive for MG. The distributions in both male and female patients were bimodal in the total and AChRAb MG cases but not in the total MuSKAb MG cases. Significant differences in the age at sampling distribution between the male and female adult patients were observed only in the AChRAb MG subtype. Significant differences between the AChRAb and MuSKAb MG categories were noted in the mean age values (60.10 and 51.49 years, respectively, for female and 65.69 and 56.19 years, respectively, for male adult patients). CONCLUSION Our findings confirm an uneven profile of age at sampling and sex between the AChRAb and MuSKAb MG cases in a large population. Future mechanistic studies can elucidate the cause of these differences. Moreover, clinical studies can explore how such differences can affect MG treatment and prognosis.
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Affiliation(s)
- Maria Belimezi
- Diagnostic Services Laboratory, Hellenic Pasteur Institute, Athens, Greece
| | | | - Juan Jiménez
- ADEMA Universitary School, University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
| | - Irene Garcia
- Department of Mathematical Sciences and Informatics, and Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
| | - Alexios-Fotios A Mentis
- Diagnostic Services Laboratory, Hellenic Pasteur Institute, Athens, Greece; University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Levadias, Athens, Greece.
| | - George P Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Levadias, Athens, Greece
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Marino C, Grimaldi M, Sabatini P, Amato P, Pallavicino A, Ricciardelli C, D’Ursi AM. Fibromyalgia and Depression in Women: An 1H-NMR Metabolomic Study. Metabolites 2021; 11:429. [PMID: 34209136 PMCID: PMC8304744 DOI: 10.3390/metabo11070429] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/15/2021] [Accepted: 06/23/2021] [Indexed: 12/18/2022] Open
Abstract
Fibromyalgia is a chronic and systemic syndrome characterized by muscle, bone, and joint pain. It is a gender-specific condition with a 9:1 incidence ratio between women and men. Fibromyalgia is frequently associated with psychic disorders affecting the cognitive and emotional spheres. In the reported work, we compared 31 female fibromyalgia patients to 31 female healthy controls. They were analyzed for biochemical clinical parameters, for autoimmune markers, and were subjected to 1H-NMR metabolomics analysis. To identify a correlation between the metabolomic profile and the psychic condition, a subset of 19 fibromyalgia patients was subjected to HAM-A and HAM-D Hamilton depression tests. Multivariate statistical analysis showed the dysmetabolism of several metabolites involved in energy balance that are associated with systemic inflammatory conditions. The severity of depression worsens dysmetabolic conditions; conversely, glycine and glutamate, known for their critical role as neuromodulators, appear to be potential biomarkers of fibromyalgia and are associated with different severity depression conditions.
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Affiliation(s)
- Carmen Marino
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
| | - Manuela Grimaldi
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
| | - Paola Sabatini
- U.O.C. Clinical Pathology D.E.A. III Umberto I, Viale S. Francesco D’Assisi, 84014 Nocera Inferiore, Italy;
| | - Patrizia Amato
- ASL Ser. T Cava de’ Tirreni, Piazza Matteo Galdi 1/3, 84013 Pregiato, Italy;
| | - Arianna Pallavicino
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
| | - Carmen Ricciardelli
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
| | - Anna Maria D’Ursi
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
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Gullo G, Cucinella G, Perino A, Gullo D, Segreto D, Laganà AS, Buzzaccarini G, Donarelli Z, Marino A, Allegra A, Maranto M, Carosso AR, Garofalo P, Tomaiuolo R. The Gender Gap in the Diagnostic-Therapeutic Journey of the Infertile Couple. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126184. [PMID: 34201025 PMCID: PMC8227607 DOI: 10.3390/ijerph18126184] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 11/19/2022]
Abstract
Medical procreation impairs both the biological and psychological lives of couples. However, male and female attitudes to infertility are different and require a different approach during the IVF journey. Thus, the gender impact assessment (GIA) method was used to analyse original studies present in the literature. We found some gender-related differences and, subsequently, possible outcomes of intervention to improve healthy reproduction management and prevent infertility. In particular, it became apparent that there was the need for an in-depth male infertility assessment and a gender-specific follow-up.
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Affiliation(s)
- Giuseppe Gullo
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.); (M.M.)
| | - Gaspare Cucinella
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.); (M.M.)
| | - Antonio Perino
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.); (M.M.)
| | - Domenico Gullo
- Technical Panel on Gender Medicine-Sicily Regional Health Service, 90143 Palermo, Italy; (D.G.); (D.S.); (P.G.)
| | - Daniela Segreto
- Technical Panel on Gender Medicine-Sicily Regional Health Service, 90143 Palermo, Italy; (D.G.); (D.S.); (P.G.)
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, 21100 Varese, Italy;
| | - Giovanni Buzzaccarini
- Department of Women’s and Children’s Health, Padova Hospital, University of Padova, 35128 Padova, Italy
- Correspondence:
| | - Zaira Donarelli
- Psychology Unit, Andros Day Surgery Clinic-Palermo, 90144 Palermo, Italy;
| | - Angelo Marino
- Reproductive Medicine Unit, Andros Day Surgery Clinic-Palermo, 90144 Palermo, Italy; (A.M.); (A.A.)
| | - Adolfo Allegra
- Reproductive Medicine Unit, Andros Day Surgery Clinic-Palermo, 90144 Palermo, Italy; (A.M.); (A.A.)
| | - Marianna Maranto
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.); (M.M.)
| | - Andrea Roberto Carosso
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science, University of Turin, 10126 Turin, Italy;
| | - Piernicola Garofalo
- Technical Panel on Gender Medicine-Sicily Regional Health Service, 90143 Palermo, Italy; (D.G.); (D.S.); (P.G.)
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Yerges AL, Snethen JA, Carrel AL. Adolescent Girls With Overweight and Obesity Feel Physically Healthy and Highlight the Importance of Mental Health. SAGE Open Nurs 2021; 7:23779608211018523. [PMID: 34104716 PMCID: PMC8165867 DOI: 10.1177/23779608211018523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/27/2021] [Indexed: 12/05/2022] Open
Abstract
Introduction Obesity in adolescence is a significant ongoing public health problem that has not improved over the past decade. Objective This descriptive qualitative study explores the perspective of female adolescents who are overweight or obese regarding their views on health and weight within the clinic setting. Methods In-depth interviews were conducted with female adolescents (age 13–19 years old; BMI ≥85th percentile) from the mid-west region of the United States (N = 28). Inductive thematic analysis using Braun & Clarke’s methods was utilized. Results The findings from this study revealed that the adolescents’ view of health encompasses physical, mental, and psychosocial health dimensions, and despite being overweight and obese, the participants felt healthy. Participants discussed the need to eat healthier and increase their daily physical activity, but were unable to transform this into action. Within the clinical setting, the adolescents were sensitive to weight discussions. Conclusion Results from this study can increase providers’ understanding of the adolescent, increase awareness of adolescent sensitivity, and assist researchers in developing age-appropriate interventions for effective treatment and prevention of childhood obesity.
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Affiliation(s)
- April L Yerges
- University of Wisconsin-Milwaukee, College of Nursing, Madison, United States
| | - Julia A Snethen
- University of Wisconsin-Milwaukee, College of Nursing, Madison, United States
| | - Aaron L Carrel
- School of Medicine and Public Health, University of Wisconsin, Madison, United States
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Patruno C, Nisticó SP, Fabbrocini G, Napolitano M. Trotula de Ruggiero and the birth of gender medicine. Ital J Dermatol Venerol 2021; 157:107-108. [PMID: 34044507 DOI: 10.23736/s2784-8671.21.06969-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Steven P Nisticó
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Maddalena Napolitano
- Department of Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy -
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The Gender Impact Assessment among Healthcare Workers in the SARS-CoV-2 Vaccination-An Analysis of Serological Response and Side Effects. Vaccines (Basel) 2021; 9:vaccines9050522. [PMID: 34070196 PMCID: PMC8158485 DOI: 10.3390/vaccines9050522] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 02/06/2023] Open
Abstract
Healthcare professionals are considered to be at high risk of exposure and spread of SARS-CoV-2, and have therefore been considered a priority group in COVID-19 vaccination campaign strategies. However, it must be assumed that the immune response is influenced by numerous factors, including sex and gender. The analysis of these factors is an impact element for stratifying the population and targeting the vaccination strategy. Therefore, a large cohort of healthcare workers participating in the Italian vaccination campaign against SARS-CoV-2 has been studied to establish the impact of sex and gender on vaccination coverage using the Gender Impact Assessment approach. This study shows a significant difference in the antibody titers among different age and sex groups, with a clear decreasing trend in antibody titers in the older age groups. Overall, the serological values were significantly higher in females; the reported side effects are more frequent in females than in males. Therefore, disaggregated data point out how the evaluation of gender factors could be essential in COVID-19 vaccination strategies. On this biomedical and social basis, suggestions are provided to improve the SARS-CoV-2 vaccination campaign in healthcare professionals. Still, they could be adapted to other categories and contexts.
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47
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Marques EB, Souza KPD, Alvim-Silva T, Martins ILF, Pedro S, Scaramello CBV. Nutrition and Cardiovascular Diseases: Programming and Reprogramming. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20200031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Shin S, Park EH, Kang EH, Lee YJ, Song YW, Ha YJ. Sex differences in clinical characteristics and their influence on clinical outcomes in an observational cohort of patients with rheumatoid arthritis. Joint Bone Spine 2020; 88:105124. [PMID: 33346105 DOI: 10.1016/j.jbspin.2020.105124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 11/22/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Rheumatoid arthritis (RA) is more prevalent in women, but sex differences remain incompletely understood. This study aimed to elucidate sex differences in clinical characteristics and their potential impact on clinical outcomes in a large Korean cohort of patients with RA. METHODS In total, 5376 RA patients from the KORean Observational study Network for Arthritis (KORONA) database were examined at baseline and for 3 consecutive years using the disease activity score 28 (DAS28), health assessment questionnaire (HAQ), and patient-reported outcomes (PROs). Within a subgroup with active disease (DAS28≥3.2) at baseline, sex impacts on clinical outcome during follow-up were analyzed using generalized estimating equation (GEE) models. The factors related to achieving clinical remission were analyzed using Cox-proportional hazard regression. RESULTS At baseline, women (n=4574) were younger and had more erosive disease and longer disease duration than men (n=802) with higher scores in DAS28, HAQ, and PROs. The prevalence of interstitial lung disease, cardiovascular disease, and diabetes in men was higher than that of women. In a RA subgroup with active disease at baseline, GEE analyses demonstrated that women RA significantly influenced the rate of change of DAS28 over time. In that group, men are associated with achieving DAS28 sustained remission and point remission. CONCLUSIONS Women with RA in Korea report higher levels of disease activity and PROs compared to men, whereas most comorbidities were more prevalent in men. The longitudinal change in disease activity and the rate of achieving clinical remission were found to be worse in women with RA.
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Affiliation(s)
- Seunghwan Shin
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
| | - Eun Hye Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
| | - Eun Ha Kang
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
| | - Yun Jong Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
| | - Yeong Wook Song
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - You-Jung Ha
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.
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Lindsay S, Kolne K. Understanding clinicians' strategies for providing gender-sensitive care: an exploration among pediatric rehabilitation health care providers. Disabil Rehabil 2020; 44:2437-2447. [PMID: 33096004 DOI: 10.1080/09638288.2020.1836270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE Although there is an increasing awareness of the critical role of gender within pediatric rehabilitation, little is known about the strategies that clinicians use to provide such care. The purpose of this study was to explore clinicians' strategies for providing gender-sensitive care within a pediatric rehabilitation hospital. METHODS We used a qualitative needs assessment design and a convenience sampling strategy to recruit clinicians from a pediatric rehabilitation hospital. We conducted interviews with 23 pediatric rehabilitation health care providers from various disciplines. We applied a thematic analysis to the interview transcripts. RESULTS Our analysis revealed the following themes regarding clinicians' strategies in providing gender-sensitive care: (1) awareness of gender biases and not making assumptions; (2) recognizing gender-based vulnerabilities; (3) respecting patient values, preferences and needs; and (4) advocacy. CONCLUSION Health care providers working within pediatric rehabilitation have several strategies for providing a gender-sensitive care approach to clients.IMPLICATIONS FOR REHABILITATIONClinicians should seek training (i.e., appropriate terminology, creating inclusive spaces) in how to recognize gender-based health vulnerabilities, especially among patients who identify as non-binary or transgender.Clinicians should make an effort to try to be aware of their own biases and not make gender-based assumptions.Advocacy, respecting patient values, preferences and needs are important aspects of providing gender-sensitive care.
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Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital & Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Kendall Kolne
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital & Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
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Machluf Y, Chaiter Y, Tal O. Gender medicine: Lessons from COVID-19 and other medical conditions for designing health policy. World J Clin Cases 2020; 8:3645-3668. [PMID: 32953842 PMCID: PMC7479575 DOI: 10.12998/wjcc.v8.i17.3645] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/29/2020] [Accepted: 08/12/2020] [Indexed: 02/05/2023] Open
Abstract
Gender-specific differences in the prevalence, incidence, comorbidities, prognosis, severity, risk factors, drug-related aspects and outcomes of various medical conditions are well documented. We present a literature review on the extent to which research in this field has developed over the years, and reveal gaps in gender-sensitive awareness between the clinical portrayal and the translation into gender-specific treatment regimens, guidelines and into gender-oriented preventive strategies and health policies. Subsequently, through the lens of gender, we describe these domains in detail for four selected medical conditions: Asthma, obesity and overweight, chronic kidney disease and coronavirus disease 2019. As some of the key gender differences become more apparent during adolescence, we focus on this developmental stage. Finally, we propose a model which is based on three influential issues: (1) Investigating gender-specific medical profiles of related health conditions, rather than a single disease; (2) The dynamics of gender disparities across developmental stages; and (3) An integrative approach which takes into account additional risk factors (ethnicity, socio-demographic variables, minorities, lifestyle habits etc.). Increasing the awareness of gender-specific medicine in daily practice and in tailored guidelines, already among adolescents, may reduce inequities, facilitate the prediction of future trends and properly address the characteristics and needs of certain subpopulations within each gender.
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Affiliation(s)
- Yossy Machluf
- Shamir Research Institute, University of Haifa, Kazerin 1290000, Israel
| | - Yoram Chaiter
- The Israeli Center for Emerging Technologies in Hospitals and Hospital-based Health Technology Assessment, Shamir (Assaf Harofeh) Medical Center, Zerifin 7030100, Israel
| | - Orna Tal
- The Israeli Center for Emerging Technologies in Hospitals and Hospital-based Health Technology Assessment, Shamir (Assaf Harofeh) Medical Center, Zerifin 7030100, Israel
- Shamir (Assaf Harofeh) Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 7030100, Israel
- Department of Management, Program of Public Health and Health System Administration, Bar Ilan University, Ramat Gan 5290002, Israel
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